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Healthcare Network Development Specialist

2 months ago

Wailuku, Hawaii, United States UnitedHealthcare Full time
About the Role

We're seeking a skilled Healthcare Network Development Specialist to join our team at UnitedHealthcare. As a key member of our network contracting team, you'll play a critical role in developing and supporting provider networks, guiding unit cost management activities, and driving financial and network pricing modeling, analysis, and reporting.

Key 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
Requirements
  • 3+ years of experience in a network management-related role, such as contracting or provider services
  • 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
  • 2+ years of experience in performing network adequacy analysis
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Intermediate level of knowledge of claims processing systems and guidelines
About UnitedHealthcare

At UnitedHealthcare, we're committed to helping people live healthier lives and making the health system work better for everyone. We believe in creating a healthier atmosphere by fostering diversity and inclusion in our workplace. 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.

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