Senior Provider Network Contract Manager

UnitedHealth Group; West Des Moines (IA); Remote; USD 92,000 - 164,000; Full time

Benefits offered by this job

Telecommuter policy

401k contribution

Equity stock purchase

Incentive programs

Job summary

UnitedHealthcare, part of UnitedHealth Group, seeks a senior network management leader to guide provider networks and unit cost management through pricing modeling and reporting. You'll negotiate contracts, build competitive networks, and lead financial analyses.

This remote role offers CST hours Mon-Fri 8:00 am–5:00 pm and a comprehensive benefits package, including telecommuter policy and 401k with stock options; you will impact care affordability and access.

Qualifications

• 5+ years in a network management role handling complex network providers with accountability for business results.
• 5+ years in the health care industry.
• 2+ years of experience with provider contracting including pricing and financial modeling.
• Knowledge of Medicare RBRVS, DRGs and related groupers.
• Proven knowledge of provider reimbursement methodologies.
• Advanced proficiency with MS Office Suite and SharePoint.
• Excellent verbal and written communication; ability to convey complex information clearly.
• Ability to work CST hours Monday to Friday, 8:00 am – 5:00 pm.

Responsibilities

• Evaluate and negotiate contracts per company templates and standards.
• Guide development of geographically competitive, broad access networks.
• Manage unit cost budgets, target setting, and financial models.
• Review work and provide recommendations for improvement.
• Forecast and plan resource requirements.
• Authorize deviations from standards.

Skills

Network management

Healthcare industry knowledge

Provider contracting

Financial modeling

Communication skills

MS Office proficiency

CST hours coordination

Tools

MS Office Suite

SharePoint

Job description

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This leadership role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. You'll guide the development and support of Provider Networks as well as unit cost management activities through financial and network pricing modeling, analysis and reporting. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

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

In this role, you will need to be able to thrive in a demanding, intense, fast-paced environment. In addition, you'll be driving some complex negotiations while focusing on ensuring accuracy.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required 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.
• Proven knowledge of provider reimbursement methodologies
• Advanced level of proficiency using MS Office Suite (Word, Excel, Outlook, PowerPoint) and SharePoint
• Proven excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
• Ability to work CST hours of Monday - Friday 8:00 am - 5:00 pm

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline:

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.