Healthcare Provider Network Contract Manager – Telecommute in CO, WY

UnitedHealth Group
Published
April 1, 2021
Location
Atlanta, GA
Category
Job Type

Description

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. Take on this managerial role with UnitedHealth Group and you'll be part of a team that's reshaping how provider networks evolve and how health care works better for millions. As a manager within our network contracting team, you'll guide the development and support of Provider Networks as well as 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 7 leader.

The candidate will develop 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, and produces an affordable and predictable product for customers and business partners. They will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. They will also establish and maintain strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties. *Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement. Generally, work is self-directed and not prescribed.

If you are located in the state of CO or WY, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Manage unit cost budgets, target setting, performance reporting and associated financial models

  • Guide development of 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

  • Provide explanations and information to others on difficult issues

  • Coach, provide feedback and guide others

  • Work with less structured, more complex issues

  • Serve as a resource to others

Get ready for some significant challenge. This is an intense, fast-paced environment that can be demanding. In addition, there are some data challenges and unique problems that need to be solved related to gaps in the process.

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:

  • 4+ years of experience in a network management-related role, such as contracting or provider services

  • 3+ years of experience in fee schedule development using actuarial models

  • 3+ years of experience using financial models and analysis to negotiate rates with providers

  • 3+ years of experience in performing network adequacy analysis

  • Contracting experience

  • Intermediate level of knowledge of claims processing systems and guidelines

  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualification:

  • Undergraduate degree

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. Find out how you can start doing your life's best work.(sm)

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

Colorado Residents Only: The salary range for Colorado residents is $64,800 to $116,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary,  UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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

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.

Job Keywords: Healthcare Provider Network Contract Manager, Provider Network Contracting, Healthcare, Managed Care, Hospital Contracting, Physician Contracting, Ancillary Contracting, Facility Contracting, Provider Network, Network Development, Provider Services, Contract Negotiating, Network Management, Accountable Care Organization (ACO), Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Denver, Colorado Springs, Pueblo, CO, Colorado, Ft. Collins, Cheyenne, Casper, WY, Wyoming

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