Network Contract Manager - Remote in Northeast U.S.

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The Network Contract Manager develops the provider network (large physician groups and other medical professionals) yielding a geographically and financially 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. Network Contract Managers evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include, but are not limited to, establishing and maintaining solid business relationships with Tier 1 provider entities, large Physician Groups, IPAs/PHOs and other medical entities, and ensuring the network composition includes an appropriate distribution of provider specialties.

For this role we seek an individual who is knowledgeable in the area of provider contracting concepts including fee for service agreements, alternative payment arrangements, performance contracting and understanding of ACO arrangements.

If you are located in the Northeast Region of the U.S., you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

Assess and interpret customer needs and requirements
Identify solutions to non-standard requests and problems
Work with minimal guidance; seek guidance on only the most complex tasks
Provide explanations and information to others on difficult issues
Establishment of relationships with large CT physician groups, PHO's, IPA's etc.
Establish relationships with internal business partners to communicate and/or navigate through certain operational requirements
Utilize knowledge of CLM and other contracting tools, acuity for financial models, and experience with performance-based contracting and ACO arrangements

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:

4 years of experience in a healthcare/provider network management-related role, such as contracting or provider services
Experience with performance-based contracting and ACO's
In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
Solid working knowledge of alternative payment methodologies such as bundled case rate payments
Ability to interpret data in financial models and make recommendations based on that data
Willing and able to travel up to 10% regionally (primarily within CT)
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifcations:

Undergraduate degree
3 years of experience in fee schedule development using actuarial models
3 years of experience utilizing financial models and analysis in negotiating rates with providers
3 years of experience in performing network adequacy analysis
Experience working with large physician groups (PHO's, IPA's, other) in CT
Experience with CLM and other contracting tools
Solid interpersonal skills, establishing rapport and working well with others
Solid customer service skills
Ability to multi-task
Excellent verbal and written communication skills

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

Connecticut Residents Only: The salary range for Connecticut residents is $72,800 to $129,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.