Network Contract Manager - Remote WA

UnitedHealth Group
Seatac, WA, US
Remote
Full-time

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care.

Join us to start Caring. Connecting. Growing together.

In support of OCN’s mission, vision, and strategic goals, the Network Contract Manager is responsible for the identification and negotiation of contracts with a variety of providers which may include hospitals, skilled nursing facilities, physicians, and ancillary providers in geographically diverse areas for both existing and developing provider networks.

Ensure proper administration of contracts through assessment of network adequacy requirements, provider needs, coordination of contract documentation, and interfacing with Heath Care Economics, Claims, Care Management, Network Engagement, and other departments.

If you reside in Washington state, you’ll enjoy the flexibility to work remotely

as you take on some tough challenges.

Primary Responsibilities :

  • 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 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 :

  • 4+ years of experience in a network management-related role, such as contracting or provider services
  • 3+ years of experience in fee schedule development using actuarial models
  • 3+ years of experience using financial models and analysis to negotiate rates with providers
  • 3+ years of experience in performing network adequacy analysis
  • Intermediate level of knowledge of claims processing systems and guidelines
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Based in WA
  • Ability to travel up to 25%
  • All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Washington Residents Only : The salary range for this role is $70, to $, annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc.

In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and k contribution (all benefits are subject to eligibility requirements).

No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.

We believe everyone of every race, gender, sexuality, age, location and income deserves the opportunity to live their healthiest life.

Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.

We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere : OptumCare is an Equal Employment Opportunity / Affirmative Action employers 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.

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

12 days ago
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