Sr Network Contract Manager - Remote - Remote Eligible

Caring. Connecting. Growing Together

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.

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.

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 striving to ensure accuracy.

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

Primary 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 standards
• Develops the provider network (primary care and specialty care physicians, ancillary groups, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management and produces an affordable and predictable product for customers and business partners
• Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
• Establishes and maintains solid business relationships with Physicians and Ancillary providers and ensures the network composition includes an appropriate distribution of provider specialties.
• Reviews the work of others
• Develops innovative approaches
• Sought out as expert
• Serves as a leader/mentor

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
• Proven in-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)

Preferred Qualifications

• Knowledge of Ambulatory, Surgery Center Groupers, etc.

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 $89,900 to $160,600 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.