Healthcare Provider Network Contract Manager - Mountain Region

Company: UnitedHealth Group
Location: Cheyenne
Posted on: November 20, 2022

Job Description:

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) It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. Take on this managerial role with UnitedHealth Group and you'll be part of a team that's reshaping how provider networks evolve and how health care works better for millions. As a manager within our network contracting 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. As you do, 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
• 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
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Intermediate level of knowledge of claims processing systems and guidelines Preferred Qualifications:
    • Undergraduate degree
    • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 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) Colorado Residents Only: The salary range for Colorado residents is $66,100 to $118,300. 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 401k 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. 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.

Keywords: UnitedHealth Group, Cheyenne , Healthcare Provider Network Contract Manager - Mountain Region, Executive , Cheyenne, Wyoming