Network Contract Manager, UHN - Remote

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Network Contract Manager for UHN develops 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. Network Contract Managers 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 with providers and ensuring the network composition includes an appropriate distribution of provider specialties.

If you reside in EST, CST, or MST, you'll enjoy the flexibility to work remotely * as you take on some tough challenges.  

Applicants must be willing to work Monday-Friday 8-5 EST.

Primary Responsibilities:

• Primarily responsible for Physician Contracting supporting the PA/DE markets
• Managing relationships with providers 
• Manage unit cost budgets, target setting, performance reporting and associated financial models
• Guide development of the network and negotiate agreements with Physicians and Medical Groups 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
• Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
• Provide explanations and information to others on difficult issues
• Work cross functionally to facilitate resolution of issues
• Position will support physicians, FQHC/RHC, urgent care and other ancillary contracting for all lines of business as deemed necessary

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 with contract review, creation, and negotiation in a network management-related role
• 2+ years of experience using financial models and analysis to negotiate rates with providers
• Intermediate level of proficiency using MS Office Word, Excel and PowerPoint
• Intermediate level of knowledge of claims processing systems and guidelines
• Willing and able to work Eastern hours  
• Access to reliable transportation and valid US driver's license

Preferred Qualifications:

• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
• Experience conducting provider meetings and negotiations in-person or virtually
• Advanced competency of Excel, including pivot tables
• Willing and able to travel up to 10% +/- depending on business need (PA/DE, onsite meetings, providers, etc.)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.  

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.

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.

#RPO, #GREEN