Network Contract Manager – Telecommute

UnitedHealth Group
Published
July 2, 2021
Location
Atlanta, GA
Category
Job Type

Description

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

If you are located in South East, East Coast or Pacific Northwest, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Manage performance target setting, performance reporting and associated financial models relative to provider network contracting
  • Guide development of geographically competitive, broad access, stable networks that achieve objectives
  • Evaluate, understand 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 specialty types  
  • Influence and/or provide input to forecasting and planning activities for network growth
  • Establish and maintain strong business relationships with assigned providers and internal partners
  • Research provider footprint and evaluate for gap filling

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:

  • Undergraduate degree or work 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 in managing a team 
  • 3+ years of experience contributing to the development of a provider network
  • Advanced level of knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
  • 3+ years of experience with direct provider contracting, including facility, physician and ancillary
  • Intermediate proficiency with MS Office, and ability to interpret and make decisions on outputs from Mapping Software (MapPoint)  
  • 2+ years of project management or project lead experience
  • Experience with client-facing responsibilities, including issue resolution, negotiations, expectation management and ongoing reviews
  • 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 Qualifications:

  • Understanding of billing and payment methodologies and willingness to learn as the industry changes
  • Knowledge and understanding of military protocol 
  • Database experience
  • Experience and accustomed to building brand networks
  • Experience using standard analytics to determine priorities to determine network contracting priorities, and determining what solutions are best for structure

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to 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/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: Provider contracting, Network contracting, MapPoint, RBRVS, Provider Network, management, leadership, military protocol, large networks, network analysis, network data, geographic approach, negotiations, facility and ancillary

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