Manager Network Contracting - Multiple Locations

Position Description

You get it. Everyone gets it. The health care system needs to evolve even further than it has and it has to do so quickly. New models of care and new networks of providers are emerging now to better serve patients and communities. And leaders like UnitedHealth Group are playing a lead role. Here's where you come in. As a participant in our network management 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. The market has a Commercial, Medicare Advantage and Managed Medicaid product which enables a wide variety of strategic opportunities for creative projects and self-growth. You'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.

Primary Responsibilities:

  • Manage unit cost budgets, target setting, performance reporting and associated financial models
  • Predict emerging customer needs and develop innovative solutions to meet them
  • Help develop 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, established financial targets and other key process controls
  • Ensure that network composition includes an appropriate distribution of provider specialties
  • Have confidence in leading groups and handling difficult discussions and making decisions with facts and data you have accumulated
  • Be responsible for follow up items and managing project plans either on your own or with a cross functional team
Get ready for a high impact role. You'll be tasked with working in conjunction with our national clinics and hospitals to manage, collect and analyze provider data, updating and loading provider data and resolving any escalated issues with the clients.

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
  • 5+ years of experience in a network management-related role handling complex network providers with accountability for business results
  • 3+ years of experience being in an external facing role, representing your organization with clients, vendors and/or government officials
  • 3+ years of experience managing complex meetings and/or projects
  • 2+ years of experience with provider contracting
  • 2+ years of experience using financial models and analysis to negotiate rates with providers
  • 2+ years of experience in performing network adequacy analysis
  • Financial acumen and ability to understand financial modeling and trending
  • Superior writing skills and ability to convey complex matters in a streamlined manner to a variety of management levels
  • Able and willing to travel up to 25% regionally
Preferred Qualifications:
  • In-depth knowledge of Medicare Diagnostic Related Group (DRG)
  • Expert level of knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
  • Intermediate level of knowledge of claims processing systems and guidelines
  • Advanced competency of excel, including pivot tables
  • Advanced competency of other Microsoft Office Suite (Outlook, Word, PowerPoint) and Sharepoint
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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)

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, health care, Contracting, Account Manager, Negotiation, Business Development


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