[Hiring] Senior Provider Network Contract Manager @UnitedHealth Group

Role Description

In this role with UnitedHealth Group, you will guide the development and support of Provider Networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting. If you reside in the state of Tennessee, you will have the flexibility to work remotely* as you take on some tough challenges.

• 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 with a focus on hospitals, clinics, and ancillary providers
• Forecast and plan resource requirements
• Authorize deviations from standards

In this role you will be expected to:

• Demonstrate expertise in provider network functions, ability to work in a fast-paced environment
• Take initiative and use problem-solving skills for issue resolution
• Work independently with little need for instruction, guidance, or direction
• Be attentive to detail, work with flexibility, and have the capability of multi-tasking to meet deadlines and deliverables
• Exhibit analytical and problem-solving skills, with a demonstrated ability to gather, understand, and evaluate information from various sources
• Prioritize and manage concurrent, and occasionally, competing initiatives

*Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement.

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
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
• Driver’s License and access to reliable transportation

Requirements

• Experience with performance-based contracts
• Intermediate level of knowledge of claims processing systems and guidelines
• *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)
• Salary range: $91,700 - $163,700 annually based on full-time employment

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. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.

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.