Senior Network Contract Strategist – Remote

Taleo; Draper (UT); Remote; USD 92,000 - 164,000; Full time

Job summary

UnitedHealth Group is seeking a Senior Network Contract Manager to build and maintain a high-quality specialty provider network. This remote role supports nationwide contracting efforts, negotiates rates, ensures network adequacy, and partners with Medical Directors, finance, and operations.

You will lead provider negotiations, drive strategic network growth, and ensure compliant, high-performing networks across payer contracts while traveling up to 25% as needed.

Qualifications

• 3+ years of experience in a healthcare network management-related role, such as contracting or provider services.
• 3+ years of experience in fee schedule development using actuarial models.
• 3+ years of experience using financial models and analysis to negotiate rates with providers.
• 3+ years of experience in performing network adequacy analysis.
• 2+ years working with a managed care organization or health insurer; or as a consultant in a network/contract management role, such as contracting, provider services, etc.
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS).
• Intermediate level of knowledge of claims processing systems and guidelines.

Responsibilities

• Works within department strategic vision, objectives, and policies and procedures.
• Regularly meet with cross-functional team to assist in creating, evaluating and adjusting strategy for assigned provider groups to meet overall performance goals.
• Establish and maintain effective business relationships with potential and existing network providers on behalf of the organization.
• Participate in various department, leadership, or cross-functional meetings including Medical Directors, finance, operational team, and clinical staff.
• Recruit/contract specialist providers to build the networks in alignment with the overall growth strategy.
• Negotiate new contracts to ensure maximum revenue, operational efficiency and compliance.
• Play key role in the creation of local network and execution of network structure, assuring network adequacy and a high-performing specialist contracted network.
• Work with operational leaders to ensure effective operational implementation and adherence of payment and authorization practices.
• Ensure specialist providers understand the Optum Care model to navigate AR and prior auth processes and meet quality goals.
• Maintain open and trusting communication with specialist providers and direct them to appropriate network managers.
• Collaborate, communicate, and manage specialist provider relationships including data forms, provider directories, system access, and questions.
• Request detailed analysis of performance data to identify opportunities to improve network construction.
• Assess and interpret customer needs and requirements.
• Identify solutions to non-standard requests and problems.
• Work with minimal guidance; seek guidance on complex tasks.
• Translate concepts into practice and coach others.
• Engage directly with senior-level management and providers.
• Demonstrate benefits of reimbursement methodologies to internal partners and providers.
• Influence and build credibility with a wide range of stakeholders.
• Interpersonal skills to interface with physicians, staff, executives, and health plan staff.
• Prioritize and organize own work to meet deadlines.
• Seek market intelligence information from relevant sources.
• Work in a matrixed management environment and communicate effectively.
• Demonstrate strong verbal and written communications and data analysis skills.
• Present to both small and large groups.
• Travel up to 25% in Colorado geography (Denver area mostly).
• MS Office proficiency (Word, PowerPoint, Excel, Teams).
• Knowledge of Medicare reimbursement methodologies (RBRVS, CPT/HCPCS).
• Knowledge of CMS-HCC Risk Adjustment Factor.

Skills

Healthcare contracting

Contract negotiation

Financial modeling

Network adequacy analysis

Relationship management

Data interpretation

MS Office

Travel flexibility

Education

Undergraduate degree or equivalent

Job description

UnitedHealth Group is seeking a Senior Network Contract Manager to build and maintain a high-quality specialty provider network. This remote role supports nationwide contracting efforts, negotiates rates, ensures network adequacy, and partners with Medical Directors, finance, and operations.

You will lead provider negotiations, drive strategic network growth, and ensure compliant, high-performing networks across payer contracts while traveling up to 25% as needed.