[Hiring] Network Contract Manager @UnitedHealth Group

Role Description

Network Contract Managers develop the provider network, 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. They evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining solid business relationships and ensuring the network composition includes an appropriate distribution of provider specialties.

If you are located in PA, you will have the flexibility to work remotely* 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 and trend management
• Evaluate and negotiate contracts, reimbursement methodologies and rates in compliance with company templates, reimbursement structure standards and other key process controls
• Ensure that network composition includes an appropriate distribution of provider and specialties and overall recruitment and contracting to ensure network adequacy
• Work with internal contacts to implement regulatory requirements impacting provider contracts (state specific changes to state published rates, coding, new services and requirements)
• Maintain existing network contracts and any contracting events that occur during the term of the agreement while generating savings opportunities for affordability initiatives
• Coordinate high profile negotiations, build and nurture trusted relationships with providers and internal stakeholders
• Engage facility and hospital providers and any internal resources to resolve issues related to contract administration
• Provide explanations and information to others on difficult issues

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 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.

Qualifications

• 2+ years of experience in a network management-related role, such as contracting or provider services
• Experience utilizing financial models and/or financial analysis for the purpose of negotiating rates with providers or to meet other business needs
• Experience in performing network adequacy analysis
• Demonstrated knowledge of Medicaid and/or Medicare
• Demonstrated intermediate level of knowledge of claims processing systems and guidelines
• Proven excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
• Driver’s License and access to reliable transportation

Requirements

• Experience in Payment Appendix and fee schedule development
• Experience with New York Medicaid services and reimbursement methodologies
• Behavioral Health provider experience
• Facility/Hospital contracting experience
• Demonstrated knowledge of the PA/Northeast market
• Proven sound interpersonal skills, establishing rapport and working well with others
• Proven sound customer service skills

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

Company Description

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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