16 days old

Network Contract Manager - Telecommute (commutable to MA or RI - 918616

Boston, MA 02109 Work Remotely
  • Job Code
    918616

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)

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The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This leadership role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. Youll 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, youll discover the impact you want and the resources, backing and opportunities that youd expect from a Fortune 7 leader.

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The Network Contract Manager develops the provider network (physicians) 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. 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 Physician or Ancillary providers and ensuring the network composition includes an appropriate distribution of provider specialties.

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If you are located within the state of MA or RI, you will have the flexibility to telecommute* as you take on some tough challenges.

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Primary Responsibilities:

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  • Manage unit cost budgets, target setting, performance reporting and associated financial models
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  • Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance, trend management and appropriate distribution of provider specialties
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  • Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
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  • Coach, provide feedback, and guide others
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  • Act as a resource for others with less experience
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  • Forecast and plan resource requirements
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  • Solve moderately complex problems and / or conduct moderately complex analyses
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  • Work with minimal guidance; seek guidance on only the most complex tasks
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  • In this role, you will need to be able to thrive in a demanding, intense, fast-paced environment. In addition, youll be driving some complex negotiations while striving to ensure accuracy.
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"Youll 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.

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Required Qualifications:

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  • Undergraduate degree or equivalent experience
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  • 1+ years of experience in a network management-related role handling complex network providers with accountability for business results
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  • 2+ years ofexperience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
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  • Intermediate level of knowledge of claims processing systems and guidelines
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  • Intermediate proficiency with Excel and other Microsoft office products
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  • 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
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Preferred Qualifications:

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  • 5+ years of experience in the health care industry
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  • Working knowledge and understanding of managed care principles and practices, experience in fee for service and value-based payment models
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  • Demonstrated analytical skills, including financial modeling and reimbursement technologies, proficient in spreadsheet and database programs as well as legal and contractual compliance issues
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  • Demonstrated ability to operate collaboratively as part of a team
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  • Build and continuously foster relationships with internal and external counterparts and other key stakeholders
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  • Identify, research, and organize key information required for contract negotiations; and, in conjunction with department leadership, develop negotiating strategy and tactics and organize and lead external contract negotiations
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  • Develop and present complex presentation materials (incorporating financial terms) for a variety of audiences including senior leadership
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  • Develop written proposals for contract negotiations and complex contract language to reflect negotiated agreements, considering potential implications across the organization
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  • Interpret contract language and respond to questions from internal and external constituents
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  • Self-motivated individual with the ability to function in a fast-paced environment with limited supervision and direction
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  • Ability to handle multiple tasks and priorities
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"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 thats second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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For more information on our Internal Job Posting Policy, click here.

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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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Medicaid, hospital contracts, contract renewals, providers, physician contractors, hospital contractors, healthcare, value-based contracts, alternative payment methodologies, Accountable Care Organizations, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Boston, MA, RI, Rhode Island

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Posted: 2021-03-25 Expires: 2021-04-24

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Network Contract Manager - Telecommute (commutable to MA or RI - 918616

UnitedHealth Group
Boston, MA 02109

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