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 Network Contracting 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. This position will 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 5 leader.
If you are located in Arkansas, Tennessee, Alabama, Mississippi, or Louisiana, you will have the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities
- Contracting for provider contracts for all lines of business such as commercial, Medicare, Medicaid, DSNP (M&R, E&I, C&S).
- 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 physician 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
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
- Undergraduate degree or equivalent experience
- 3+ years of experience in a network management-related role, such as contracting or provider services
- 2+ years of experience in fee schedule development and analysis to negotiate rates with providers
- 2+ years of experience in performing network adequacy analysis
- Strong negotiation skills and ability to provide conflict resolution
- Intermediate level of knowledge of claims processing systems and guidelines
- Must reside within a state of this specific career opportunity (AR, TN, AL, MS, LA)
- Willing and able to travel up to 25%
Preferred Qualifications
- CLM/Emptoris Contracting experience
- Experience with MSPS (market standard pricing schedule)
- Knowledge of Medicare Resource Based Relative Value System (RBRVS)
- Expertise within Commercial, Medicare, Medicaid and/or DSNP (M&R, E&I, C&S).
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/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: Network Contract, Negotiator Manager, Telecommute, AR, TN, AL, MS, LA, Arkansas, Tennessee, Alabama, Mississippi, Louisiana, Healthcare, Contracting, Account Manager, Negotiation, Business Development, Manager, Consultant