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Network Contract Manager - Remote In Western US Preferred - Remote Eligible

Negotiate regional provider contracts to improve access and reduce costs
Houston
Senior
$71,200 – 127,200 USD / year
8 hours agoBe an early applicant
UnitedHealth Group

UnitedHealth Group

A diversified health and well-being company offering a broad spectrum of products and services through two distinct platforms: UnitedHealthcare and Optum.

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Join Optum

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Creating and fine-tuning provider networks helps improve access to health care for millions. It's an outstanding opportunity to have more meaning and purpose in your career.

Primary focus will be the states of CA, CO and ID.

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

Primary Responsibilities:

  • Negotiate and prepare facility and outpatient agreements that are geographically competitive
  • Achieve objectives for unit cost performance and trend management
  • Prepare and negotiate value-based, performance-based, and creative contracts for assigned regional facilities
  • Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards, and other key process controls
  • Collaborates with Provider Network team to ensure that network composition includes an appropriate distribution of provider specialties
  • Participate in regional and state-based contracting and/or provider network calls; Possess a willingness and ability to provide explanations and information to others on difficult and/or complex contracting issues (i.e. subject matter expert)

Get ready for some significant challenge. This is an intense, fast-paced environment that can be demanding.

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:

  • 3+ years of experience in provider contracting related role or network management and provider services
  • 3+ years of experience using financial models and analysis to negotiate rates with providers
  • In-depth knowledge of fee-for-service (FFS), risk sharing, and value-based or "creative" contracting
  • Intermediate level of knowledge of claims processing systems and guidelines
  • Demonstrable knowledge of managed care contracting concepts, provider network access, and CMS and Medicaid rules

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 $71,200 to $127,200 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.

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Network Contract Manager - Remote In Western US Preferred - Remote Eligible
Houston
$71,200 – 127,200 USD / year
Registered Nurse
About UnitedHealth Group
A diversified health and well-being company offering a broad spectrum of products and services through two distinct platforms: UnitedHealthcare and Optum.