Network Contract Manager

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

What makes your career greater with UnitedHealth Group? Growth opportunities among the variety of product lines and making an impact on the healthcare system ensures it will always be challenging and exciting. The Network Contract Manager develops the provider network (physicians, hospitals, pharmacies, ancillary groups and facilities, etc.) 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 Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties. In this role you will be expected to:

- Assess and interpret customer needs and requirements.
- Identify solutions to non-standard requests and problems.
- Solve moderately complex problems and/or conduct moderately complex analyses.
- Work with minimal guidance; seek guidance on only the most complex tasks.
- Translate concepts into practice.
- Provide explanations and information to others on difficult issues.
- Coach, provide feedback, and guide others.
- Act as a resource for others with less experience.

Requirements:
- Undergraduate degree and/or 1-3 years experience in a network management-related role, such as contracting or provider services.
- 3 years experience in a network management-related role, such as contracting or provider services.
- In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS) preferred.
- 3 years of experience utilizing financial models and analysis in negotiating rates with providers.
- At least an intermediate level of knowledge of claims processing systems and guidelines preferred
- 3 years of experience in performing network adequacy analysis preferred.
- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.
- Strong interpersonal skills, establishing rapport and working well with both internal and external clients.
- Strong customer service skills
UnitedHealthcare Employer Individual is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

When you work with UnitedHealthcare Employer Individual, what you do matters. It's that simple...and it's that challenging.

In providing consumer-oriented health benefit plans to millions of people, our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system.

Regardless of your role at UnitedHealthcare Employer Individual, the support you feel all around you will enable you to do what you do with energy, integrity, and confidence. So take the first step in what is sure to be a fast paced and highly diversified career.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.


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 Job Category: Business/Strategic Management
Reference Code: 364631
Position Type: Full Time, Employee