Network Contracting Manager

1 week ago

Des Moines, 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.

Network contracting manager will support the development of the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically
competitive, broad access, stable network that achieves objectives for unit cost performance and trend management. The developed network will produce an affordable and predictable product for customers and business partners.

If you are located within commutable distance of Wisconsin, Nebraska or Iowa, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Conducts outreach to potential providers
  • Supports development of the provider network (physicians, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for cost performance
  • Performs straightforward contract negotiation and pricing - evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
  • Establishes and maintains solid business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties
  • Balance financial and operational impact of contracts to providers, members, and different customer groups when developing and/or negotiating contract terms
  • Support evaluation of market rates and provider performance (e.g., billing patterns; referral patterns; quality and effectiveness) in order to establish provider rates and negotiation strategies
  • Explain the organization's direction and strategy to internal partners and providers in order to justify methodologies, processes, policies, and procedures
  • Identify and gather information regarding provider issues in order to develop and/or implement strategy to resolve matter, keep manager informed of progress, or escalate issue to appropriate internal business partner
  • Represent department in external meetings (e.g., ancillary providers; physician groups; facilities) to gather relevant information, recommend solutions, execute on deliverables as assigned and explain results/decision/activities
  • Monitor and/or oversee provider financial performance to identify opportunities to improve performance and/or provider relationship
  • Monitor and/or oversee network performance and industry trends to identify opportunities to refine, develop, and/or implement market strategies
  • Other duties as assigned
Key Work Attributes
  • Generally work is self-directed and not prescribed. Serves as a resource to others
  • Works with less structured, more complex issues
  • Ability to adapt quickly as an high growth less mature business contributes to a dynamic, fluid, high learning work environment
  • Assesses and interprets customer needs and requirements
  • Identifies solutions to non-standard requests and problems
  • Solves moderately complex problems and/or conducts moderately complex analyses
  • Works with minimal guidance; seeks guidance on only the most complex tasks
  • Coaches, provides feedback, and guides others.Acts as a resource for others
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:
  • 2+ years of experience with network contracting or provider relations in a managed care environment
  • Demonstrate understanding of and utilize applicable financial tools (e.g., HPM; PPM; FAT; HCE's RVU/Unit tool) and reports (e.g., internal financial models; external reports) to develop rates
  • Demonstrate understanding of contract language in order to assess financial and operational impact and legal implications of requested contract changes
  • Demonstrate understanding of competitor landscape within the market (e.g., rates; market share; products; provider networks; market intelligence; GeoAccess)
  • Proven ability to utilize appropriate contract management systems (e.g., Emptoris; PEGA; Contract Attachment Repository) to author and execute contracts and to access supplemental contractual documents
Physical Demands:

Rarely (Less than .5 hours/day, Occasionally (0.6 - 2.5 hours/day), Frequently (2.6 - 5.5 hours/day), Continuously (5.6 - 8.0 hours/day)
  • Standing - Occasionally
  • Sitting - Continuously
  • Walking - Occasionally
  • Kneeling/Crouching - Rarely
  • Lifting - Rarely (Light to 10 lbs)

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

  • Director - Provider Network Development & Contracting

    1 month ago

    Des Moines, United States Wellmark, Inc. Full time

    Job DescriptionJob DescriptionCompany DescriptionWhy Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re...

  • Director - Provider Network Development & Contracting

    3 weeks ago

    Des Moines, United States Wellmark, Inc. Full time

    Job DescriptionJob DescriptionCompany DescriptionWhy Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re...

  • Network Contracting Manager

    3 weeks ago

    Des Moines, 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. Network contracting manager will support the development of the provider network (physicians, hospitals, pharmacies, ancillary...

  • Provider Network Manager

    4 weeks ago

    Des Moines, United States Elevance Health Full time

    Anticipated End Date:2024-05-31 Position Title:Provider Network Manager Job Description: Location: Des Moines, Iowa Hours: Standard M - F Travel: Hybrid role (1-2 days per week in office) Position Overview: Develops the provider network through contract negotiations (language and rates), relationship development, and servicing. How You Will Make an Impact:...

  • Provider Network Manager

    1 month ago

    Des Moines, United States Elevance Health Full time

    Anticipated End Date: 2024-05-31 Position Title: Provider Network Manager Job Description: Location: Des Moines, Iowa Hours: Standard M - F Travel: Hybrid role (1-2 days per week in office) Position Overview: Develops the provider network through contract negotiations (language and rates), relationship development, and servicing. How You Will Make an...

  • Contracts Administrator

    4 weeks ago

    Des Moines, United States Arista Networks Inc Full time

    Arista Networks was founded to pioneer and deliver software-driven cloud networking solutions for large data center storage and computing environments. Arista’s award-winning platforms, ranging in Ethernet speeds from 10M to 400G bits per second, redefine scalability, agility and resilience. Arista has shipped more than 10 million cloud networking ports...

  • Contracts Administrator

    2 weeks ago

    Des Moines, United States Arista Networks Inc Full time

    Arista Networks was founded to pioneer and deliver software-driven cloud networking solutions for large data center storage and computing environments. Arista’s award-winning platforms, ranging in Ethernet speeds from 10M to 400G bits per second, redefine scalability, agility and resilience. Arista has shipped more than 10 million cloud networking ports...

  • Contracts Administrator

    1 week ago

    Des Moines, Iowa, United States Arista Networks Inc Full time

    Arista Networks was founded to pioneer and deliver software-driven cloud networking solutions for large data center storage and computing environments. Arista's award-winning platforms, ranging in Ethernet speeds from 10M to 400G bits per second, redefine scalability, agility and resilience. Arista has shipped more than 10 million cloud networking ports...

  • Network Administrattion Analyst

    1 month ago

    Des Moines, United States Wellmark Full time

    Job Description Help us lead change and transform Wellmark's business The health care industry is changing, and Wellmark is working to help change it for the better. We recognize that our members deserve health care with a focus on quality. We also recognize that health care is complex. We’ve embarked on a journey to support our members use and navigate...

  • Network Administrattion Analyst

    1 week ago

    Des Moines, Iowa, United States Wellmark Full time

    Job DescriptionHelp us lead change and transform Wellmark's businessThe health care industry is changing, and Wellmark is working to help change it for the better. We recognize that our members deserve health care with a focus on quality. We also recognize that health care is complex. We've embarked on a journey to support our members use and navigate the...

  • Network Administration Analyst

    4 weeks ago

    Des Moines, United States Wellmark Full time

    Company DescriptionWhy Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on over 80 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors-our members. If you're passionate about joining an organization...

  • Network Administration Analyst

    1 month ago

    Des Moines, United States Wellmark Full time

    Company DescriptionWhy Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on over 80 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors-our members. If you're passionate about joining an organization...

  • Network Administration Analyst

    3 weeks ago

    Des Moines, United States Wellmark Full time

    Company DescriptionWhy Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on over 80 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors-our members. If you're passionate about joining an organization...

  • Lead Network Technician

    1 month ago

    Des Moines, United States Palmer Group Full time

    Job DescriptionJob DescriptionThe Lead Network Technician will oversee an offshore team responsible for maintaining a Cisco-based network infrastructure encompassing various components such as routers, switches, and wireless controllers. If you have at least three years of experience managing Cisco network infrastructure, keep reading! Responsibilities:...

  • Lead Network Technician

    3 weeks ago

    Des Moines, United States Palmer Group Full time

    Job DescriptionJob DescriptionThe Lead Network Technician will oversee an offshore team responsible for maintaining a Cisco-based network infrastructure encompassing various components such as routers, switches, and wireless controllers. If you have at least three years of experience managing Cisco network infrastructure, keep reading!Responsibilities:...

  • Contract Utilization Management Nurses

    2 weeks ago

    Des Moines, United States Palmer Group Full time

    Job DescriptionJob DescriptionOur well-known healthcare client is searching for multiple Contract Utilization Management Nurses to join their team on a contract basis. In this role, you will be able to work fully remotely from the comfort of your home. If you’re a dynamic individual ready to share your talents and ideas with this team, apply...

  • Network Engineer

    1 month ago

    Des Moines, United States UnityPoint Health Full time

    Overview The Network Engineer's role is to build, test, and implement wide area and local area network infrastructure solutions that support multiple facilities at various sites. This includes participation in consulting services, project management, network performance and capacity, configuration management, security, automated monitoring/alerting, disaster...

  • Network Relations Specialist

    1 month ago

    Des Moines, United States Elevance Health Full time

    Anticipated End Date: 2024-05-31 Position Title: Network Relations Specialist Job Description: Location: Des Moines, Iowa Hours: Standard M - F Travel: Field Based Role (Traveling around territory as needed) Position Overview: Develops and maintains positive relationships with providers within a local health plan's LTSS/HCBS provider network. Researches and...

  • Network Relations Specialist

    4 weeks ago

    Des Moines, United States Elevance Health Full time

    Anticipated End Date:2024-05-31Position Title:Network Relations SpecialistJob Description:Location: Des Moines, IowaHours: Standard M - FTravel: Field Based Role (Traveling around territory as needed)Position Overview: Develops and maintains positive relationships with providers within a local health plan's LTSS/HCBS provider network. Researches and resolves...

  • Network Security Engineer

    1 week ago

    Des Moines, Iowa, United States GuidePoint Security Full time

    An active Top Secret/SCI clearance is required prior to consideration for this role. Work is 100% onsite. A Network Security Engineer is part of a team of skilled Cybersecurity professionals that support the design, build, and sustainment of network based cyber defense capabilities within the organization. Network Security Engineers interact daily with a...