UnitedHealth Group

Network Contract Manager - Telecommute w/in FL (South FL, Tampa or Orlando offices preferred)

Posted on: 6 Feb 2021

Miami, FL

Job Description

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

The Network Contract Manager develops the provider network (facility, physician, ancillary) 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 facility, physician, ancillary providers and ensuring the network composition includes an appropriate distribution of provider specialties.

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

Primary Responsibilities:

* Assess and interpret customer needs and requirements
* Negotiate facility, ancillary, and physician contracts
* Forecast and plan ongoing facility, physician, ancillary contract renewal strategy
* 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

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
* 2+ years of experience utilizing financial models and analysis in negotiating rates with providers
* 2+ years of experience in performing network adequacy analysis
* In - depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
* Intermediate level of knowledge of claims processing systems and guidelines
* 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

Preferred Qualifications:

* Experience with facility, physician, ancillary (or any combination there-of)
* Experience working with government programs (including but not limited to Medicare and Medicaid)
* 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 form others
* Strong interpersonal skills, establishing rapport and working well with others
* Strong customer service skills

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 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: Healthcare, Health Care, Contracting, Account Manager, Negotiation, Business Development, Manager, Consultant, Network, Facility, Hospital, Physician, Ancillary, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Miami,Tampa, Orlando, Florida, FL

UnitedHealth Group

Hopkins, MN

UnitedHealth Group Incorporated operates as a diversified health care company in the United States. It operates through four segments: UnitedHealthcare, OptumHealth, OptumInsight, and OptumRx. The UnitedHealthcare segment offers consumer-oriented health benefit plans and services for national employers, public sector employers, mid-sized employers, small businesses, and individuals; health and well-being services to individuals age 50 and older, addressing their needs for preventive and acute health care services, as well as services dealing with chronic disease and other specialized issues for older individuals; and Medicaid plans, Children’s Health Insurance Program, and health care programs; and health and dental benefits.

The OptumHealth segment provides access to networks of care provider specialists, health management services, care delivery, consumer engagement, and financial services. This segment serves individuals through programs offered by employers, payers, government entities, and directly with the care delivery systems.

The OptumInsight segment offers software and information products, advisory consulting arrangements, and services outsourcing contracts to hospital systems, physicians, health plans, governments, life sciences companies, and other organizations. The OptumRx segment provides pharmacy care services and programs, including retail network contracting, home delivery, specialty and compounding pharmacy, and purchasing and clinical, as well as develops programs in areas, such as step therapy, formulary management, drug adherence, and disease/drug therapy management. UnitedHealth Group Incorporated was founded in 1974 and is based in Minnetonka, Minnesota.

Similar Jobs