Remote Senior Network Contracting Leader

UnitedHealth Group; Los Angeles (CA); Remote; USD 92,000 - 164,000; Full time

Job summary

OptumHealth, part of UnitedHealth Group, seeks a self-directed professional to manage contracts, cost trends, relationships and network growth for Centers of Excellence through provider negotiations with major academic hospitals and health systems.

The role requires navigating complex contracting strategies and regulatory knowledge to achieve client and sales goals, while maintaining strong provider relationships. Remote work is allowed nationwide.

Qualifications

• 5 years of experience in a network management-related role handling complex network providers with accountability for business results.
• 5 years of experience in the health care industry.
• 2 years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions.
• Knowledge of Medicare and Medicaid regulations.
• In-depth knowledge of Medicare RBRVS, DRGs, Ambulatory Surgery Center Groupers, etc.
• Intermediate level of proficiency with MS Excel and other Microsoft Office applications.
• Driver's License and access to reliable transportation.

Responsibilities

• Analyze and evaluate payment appendices to strategize contracting options.
• Evaluate market rates and provider performance to establish provider rates and negotiation strategies.
• Explain the organization’s direction and strategy to providers in order to justify methodologies, processes, policies, and procedures.
• Input contract projections accurately into appropriate tools and analyze financial impact of provider contracts to achieve company goals.
• Communicate proposed contractual terms with provider and negotiate mutually acceptable agreement.
• Establish and manage relationships with providers to navigate operational, legal, financial and clinical matters.

Skills

Network management

Healthcare industry knowledge

Financial modeling

Medicare/Medicaid regulations

RBRVS/DRGs knowledge

MS Excel proficiency

Tools

MS Excel

Job description

OptumHealth, part of UnitedHealth Group, seeks a self-directed professional to manage contracts, cost trends, relationships and network growth for Centers of Excellence through provider negotiations with major academic hospitals and health systems.

The role requires navigating complex contracting strategies and regulatory knowledge to achieve client and sales goals, while maintaining strong provider relationships. Remote work is allowed nationwide.