Caring. Connecting. Growing Together.
The Regional Contract Manager will manage performance targets, reporting, and financial models while building solid, geographically competitive networks that meet organizational goals. You'll negotiate provider contracts, ensure balanced network composition, and drive growth through strategic forecasting and gap analysis. This position also involves hosting Joint Operating Committee meetings, educating accounts on compliance and best practices, and collaborating across departments to deliver creative solutions. If you're self-motivated, relationship-driven, and ready to make an impact, this is the opportunity for you!
You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Manage performance target setting, performance reporting and associated financial models relative to provider network contracting
- Guide development of geographically competitive, broad access, stable networks that achieve objectives
- Evaluate, understand, and negotiate provider contracts in compliance with company templates, reimbursement structure standards and other key process controls
- Ensure that network composition includes an appropriate distribution of provider specialty types
- Influence and/or provide input to forecasting and planning activities for network growth
- Establish and maintain solid business relationships with assigned providers and internal partners
- Research provider footprint and evaluate for gap filling
- Host Joint Operating Committee (JOC) meetings with accounts and present to senior leaders
- Educate accounts on a wide range of topics to enhance their knowledge and compliance with policies, procedures, and best practices, in collaboration with others
- Understand and engage with other departments to support all aspects of provider relations
- Develop and maintain beneficial relationships with key departments to support account management
- Think outside the box to develop creative solutions for account challenges
- Work independently with solid self-guidance and motivation
- Monitor and assist accounts' with OSHA compliance to ensure safety standards are met
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 a network management-related role handling complex network providers with accountability for business results
- Experience with client-facing responsibilities, including issue resolution and contract negotiations
- Experience performing network adequacy analysis
- Intermediate level of knowledge of claims processing systems and guidelines
- Understanding of network adequacy analytics and how to prioritize the work based on data
- Proficiency with Microsoft Suite Applications (Outlook, Excel, Word, PowerPoint, Teams)
- Proven ability to solve complex issues and unique situations
- Driver's License and access to reliable transportation
Preferred Qualifications:
- Experience with direct provider contracting, including facility, physician and ancillary
- Experience working with large accounts
- Experience with building brand new networks
- Experience working in Tableau
- Knowledge and understanding of military protocol
*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). 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.