Senior Provider Network Contract Leader (Remote)

Socket.dev; North Carolina; Remote; USD 92,000 - 164,000; Full time

Benefits offered by this job

Comprehensive benefits package

401k contribution

Equity stock purchase plan

Job summary

UnitedHealth Group is seeking a senior leader to guide Provider Networks and cost management, leveraging financial models and contract strategies to drive efficiency and network quality.

The role requires extensive healthcare industry experience, strong negotiation skills, and the ability to thrive in a fast-paced environment. Remote work options are available for eligible markets, including North Carolina.

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.
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.

Responsibilities

• Manage unit cost budgets, target setting, performance reporting and associated financial models.
• Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance, trend management and appropriate distribution of provider specialties.
• Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls.
• Review work performed by others and provide recommendations for improvement.
• Forecast and plan resource requirements.
• Authorize deviations from standard.

Skills

Network management

Healthcare industry experience

Provider contracting

RBRVS knowledge

Job description

UnitedHealth Group is seeking a senior leader to guide Provider Networks and cost management, leveraging financial models and contract strategies to drive efficiency and network quality.

The role requires extensive healthcare industry experience, strong negotiation skills, and the ability to thrive in a fast-paced environment. Remote work options are available for eligible markets, including North Carolina.