Overview

Sr Network Contract Manager – Wyoming or Denver, CO Job at UnitedHealth Group Wyoming

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)

The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This leadership role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. 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 7 leader.

In this role, you will need to be able to thrive in a demanding, intense, fast-paced environment. In addition, you’ll be driving some complex negotiations and initiatives while striving to ensure accuracy.

If you are located in Wyoming or Denver, CO, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Manage unit cost budgets, target setting, performance reporting and associated financial models
  • Guide expansion and development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance, trend management and appropriate distribution of provider specialties
  • Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
  • Manage Medicare risk-based agreements, incentives and affordability initiatives across the provider network.
  • Review work performed by others and provide recommendations for improvement
  • Authorize deviations from standards
  • Develops the provider network (physicians, hospitals, ancillary groups & 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
  • Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
  • Establishes and maintains strong business relationships with Hospital, Physician, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties
  • Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement
  • Develops innovative approaches
  • Sought out as expert
  • Serves as a leader/ mentor

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

  • 5+ years of experience in a network management-related role handling complex network providers with accountability for business results
  • 5+ years of experience in the health care industry
  • 2+ years experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
  • 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 Qualification:
Creating and fine tuning provider networks helps improve access to health care for millions. It’s an outstanding opportunity to have more meaning and purpose in your career. Join us. Find out how you can start doing your life’s best work.(sm)

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 wherever 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: Sr Network Contract Manager, Hospital, Physician, Negotiation, Contract, Medicare, Denver, CO, Colorado, Wyoming, Telecommute, Telecommuter, Telecommuting, Remote, Work from home, Work at homePandoLogic. Category: Technology, Keywords: Network Manager00 – 0

Pandologic

About the Company

Company: UnitedHealth Group

Company Location:  Wyoming

Estimated Salary:

About UnitedHealth Group