[Hiring] Regional Contract Manager @UnitedHealth Group

Role Description

The Network Contract Manager will assist in building a provider network, including physicians, hospitals, pharmacies, ancillary groups, and facilities. This network will be geographically competitive, offer broad access, and remain stable, meeting goals for cost performance and trend management. The resulting network will deliver an affordable and predictable product for customers and business partners.

• Conducts outreach to potential providers.
• Supports development of the provider network (physicians, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for cost performance.
• Performs straightforward contract negotiation and pricing - 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 Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties.
• Balances financial and operational impact of contracts to providers, members, and different customer groups when developing and/or negotiating contract terms.
• Supports evaluation of market rates and provider performance (e.g., billing patterns; referral patterns; quality and effectiveness) in order to establish provider rates and negotiation strategies.
• Explains the organization's direction and strategy to internal partners and providers in order to justify methodologies, processes, policies, and procedures.
• Identifies and gathers information regarding provider issues in order to develop and/or implement strategy to resolve matter, keeps manager informed of progress, or escalates issue to appropriate internal business partner.
• Represents department in external meetings (e.g., ancillary providers; physician groups; facilities) to gather relevant information, recommend solutions, execute on deliverables as assigned and explain results/decision/activities.
• Monitors and/or oversees provider financial performance to identify opportunities to improve performance and/or provider relationship.
• Monitors and/or oversees network performance and industry trends to identify opportunities to refine, develop, and/or implement market strategies.
• Other duties as assigned.

Qualifications

• 2+ years of experience with network contracting or provider relations in a managed care environment.
• Demonstrate understanding of and utilize applicable financial tools and reports to develop rates.
• Demonstrate understanding of contract language in order to assess financial and operational impact and legal implications of requested contract changes.
• Demonstrate understanding of competitor landscape within the market.
• Proven ability to utilize appropriate contract management systems to author and execute contracts and to access supplemental contractual documents.

Requirements

• Sales experience is highly preferred to effectively negotiate contracts and establish solid business relationships with providers.

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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.