Network Contract Manager – Telecommute

UnitedHealthcare is a company that’s on the rise. We’re expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn’t about another gadget, it’s about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life’s best work.(sm)

Take on this role with UnitedHealth Group and you’ll be part of a team that’s reshaping how provider networks evolve and how health care works better for millions. As a part of our physician network contracting team, you’ll develop the network to produce an affordable and predictable product for customers and business partners in the PA/DE Region. As you do, you’ll discover the impact you want and the resources, backing and opportunities that you’d expect from a Fortune 5 leader.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
• Manage target setting, performance reporting and associated financial models
• Develops the provider network (physicians, and ancillary groups) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management
• Establishing and maintaining strong business relationships with providers throughout PA/DE Region
• Ensure that network composition includes an appropriate distribution of provider specialties
• Provide explanations and information to others on difficult issues
• Assess and interpret customer needs and requirements
• Forecast and plan ongoing physician contract renewal strategy

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 be interested in.

Required Qualifications:

• 3+ years of experience in a network management-related role, such as contracting, revenue cycle, or provider services
• 2+ years of experience using financial models and analysis to negotiate rates with providers
• 2+ years of experience in performing network adequacy analysis
• Intermediate level of knowledge of claims processing systems and guidelines
• In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
• Ability to work Eastern Standard Time (EST) hours

Preferred Qualifications:

• Experience with facility, hospital, physician, ancillary (or any combination there-of)
• Solid interpersonal skills, establishing rapport and working well with others
• Solid customer service skills
• 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 form others

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 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)

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $66,100 to $118,300. The salary range for Connecticut / Nevada 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 Telecommuters 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.