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)
As a Senior Network Contract Manager, you 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. Senior 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 strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties.
If you are in a commutable distance from Nashville, Knoxville, Chattanooga, or Tri-Cities, you will have the flexibility to telecommute* as you take on some tough challenges.
- 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 services
- Contribute to setting team direction, resolve problems and provide guidance to members of your team
- Influence and/or provide input to forecasting and planning activities
This role is all about challenge and relationships. You'll partner with CEO's from various lines of business as we work on building effective relationships with large health systems.
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.
- Undergraduate degree or equivalent experience
- 5+ years of experience in a network management-related role handling complex network providers with accountability for business results
- 2+ years of experience contributing to financial modeling in making rate decisions and managing a medical cost and administrative budget
- 2+ years of experience with hospital or ancillary contracting
- Intermediate level of knowledge of Medicare, DRGs, Ambulatory Surgery Center Groupers, etc.
- Commutable to and abel to travel up to 25% to one of the following cities in TN (Nashville, Knoxville, Chattanooga, Tri-Cities)
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.
- Product pricing experience
- Experienced in developing and maintaining high performance network experience (tiered, narrowed, and/or ACO products)
- Knowledgeable of Resource Based Relative Value System (RBRVS) methodology
- Proficient in Tenncare regulatory requirements and reimbursement methodologies
- Skilled in negotiating value-based performance incentive programs
- Conversant in hospital clinical performance measures
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 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)
*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/AffirmativSe 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 bylower 48 law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.