Network Contract Manager - Remote

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. 

As a manager within our network contracting team, 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: 

• Recruit and contract with Facility and Outpatient/Professional providers to assure OBHS has Commercial, Medicare and Medicaid networks that meet Adequacy and Access standards, client expectations and achieve objectives for unit cost performance and trend management
• Complete contracting tasks required to negotiate provider rate increases, new service locations and new Tax ID numbers
• Complete rate renewals with providers identified for remediation opportunities and/or cost savings
• Work closely with Provider Relations Team, key internal stakeholders, and Project Managers to assure network goals are met
• Clearly communicate status of large network development and contracting initiatives to internal and external customers
• 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 and trend management
• Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
• Ensure that network composition includes an appropriate distribution of provider specialties
• Provide explanations and information to others on difficult issues
• Coach, provide feedback and guide others 
    

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: 

• 1 years of experience in a network management-related role, such as contracting or provider services, or equivalent experience
• 1 years of experience using financial models and analysis to negotiate rates with providers
• 1 years of experience with claims processing systems and guidelines 
  
  

Preferred Qualifications: 

• Undergraduate degree
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
• Understanding of managed care contract language
• Understanding of Medicaid and Medicare pricing and CMS relativity
• Contracting for behavioral health
• Knowledge of provider credentialing

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

California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $67,800 to $133,100 per year. 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. 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.    

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. 

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