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Associate Network Contract Manager

4 months ago

SeaTac, Washington, United States UnitedHealth Group Full time
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

You get it. Everyone gets it. The health care system needs to evolve even further than it has and it has to do so quickly. New models of care and new networks of providers are emerging now to better serve patients and communities. And leaders like UnitedHealth Group are playing a lead role. Here's where you come in. As member of our network contracting team, you'll help develop and support Provider Networks and guide unit cost management activities through financial and network pricing modeling, analysis, and reporting. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.

Creating and fine-tuning provider networks helps improve access to health care for millions. It's an outstanding opportunity to have more meaning and purpose in your career. Join us.

If you are based in WA or OR, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:
  • Manage unit cost budgets, target setting, performance reporting and associated financial models
  • Predict emerging customer needs and develop innovative solutions to meet them
  • Help develop geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
  • Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards, and other key process controls
  • Ensure that network composition includes an appropriate distribution of provider specialties
Get ready for a high impact role. You'll be tasked with working in conjunction with our national clinics and hospitals to manage, collect and analyze provider data, updating and loading provider data and resolving any escalated issues with the clients.

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, such as contracting or provider services
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Intermediate level of knowledge of claims processing systems and guidelines
Preferred Qualifications:
  • 2+ years of experience in performing network adequacy analysis
  • 2+ years of experience in fee schedule development using actuarial models
  • 2+ years of experience using financial models and analysis to negotiate rates with providers
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Washington Residents Only: The hourly range for this role is $28.03 to $54.95 per hour. 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.

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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment