Network Contract Manager – Remote
(Remote considered)
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Manage performance target setting, performance reporting and associated financial models relative to provider network contracting
- Guide development of geographically competitive, broad access, stable networks that achieve objectives
- Evaluate, understand, and negotiate provider contracts in compliance with company templates, reimbursement structure standards and other key process controls
- Ensure that network composition includes an appropriate distribution of provider specialty types
- Influence and/or provide input to forecasting and planning activities for network growth
- Establish and maintain strong business relationships with assigned providers and internal partners
- Research provider footprint and evaluate for gap filling
- Host Joint Operating Committee (JOC) meetings with accounts and present to senior leaders
- Educate accounts on a wide range of topics to enhance their knowledge and compliance with policies, procedures, and best practices, in collaboration with others
- Understand and engage with other departments to support all aspects of provider relations
- Develop and maintain beneficial relationships with key departments to support account management
- Think outside the box to develop creative solutions for account challenges
- Work independently with strong self-guidance and motivation
- Monitor and assist accounts with OSHA compliance to ensure safety standards are met
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:
- 3+ years of experience in a network management-related role handling complex network providers with accountability for business results
- Experience with client-facing responsibilities, including issue resolution and contract negotiations
- Experience performing network adequacy analysis
- Intermediate level of knowledge of claims processing systems and guidelines
- Understanding of network adequacy analytics and how to prioritize the work based on data
- Proven ability to solve complex issues and unique situations
Preferred Qualifications:
- 5+ years of experience with direct provider contracting, including facility, physician and ancillary
- 2+ years of experience working with large accounts
- Experience with building brand new networks
- Knowledge and understanding of military protocol
- Knowledge of relevant computer and software applications (eg. MS office, office tools, Excel, Tableau,)
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
Additional Job Detail Information
Requisition Number 2281814
Business Segment Optum
Employee Status Regular
Job Level Individual Contributor
Travel Yes, 10 % of the Time
Country: US
Overtime Status Exempt
Schedule Full-time
Shift Day Job
Telecommuter Position Yes
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