Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
This self-directed role with OptumHealth will call on your knowledge, energy and commitment to making health care work more effectively. You will manage complex provider contracts, cost trend, relationships and network growth/strategy for Optum’s Centers of Excellence provider networks (orthopedic focus) through provider negotiations with hospitals and health systems. This position is responsible for executing on network strategies to meet client and sales goals; contracting competitive rates; evolving the payment methodology; and managing provider relationships.
You’ll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.
- Analyze and evaluate bundle payment and value based strategy options for various contracting approaches and methodologies
- Evaluate market rates and provider performance (e.g., billing patterns; referral patterns; quality and effectiveness) in order to establish provider rates and negotiation strategies
- Explain the organization's direction and strategy to providers in order to justify methodologies, processes, policies, and procedures
- Input contract projections accurately into appropriate tools and analyze financial impact of provider contracts to achieve company goals
- Communicate proposed contractual terms with provider and negotiate mutually acceptable agreement
- Establish and manage relationships with providers to navigate operational, legal, financial and clinical matters
- Reviewing contract redlines and developing responses that adhere to the applicable legal, financial, regulatory, and operational requirements
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 while striving to ensure accuracy.
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.
- Undergraduate degree
- 4+ years of experience in a network management-related role handling complex network providers with accountability for business results
- 2+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
- Knowledge of bundle/case rate methodology, Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
- Knowledge of Medicare and Medicaid regulations
- Intermediate to advanced level of proficiency with MS Excel
- 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
- Value based contracting experience
- Health care economics/financial experience
- Large facility negotiations experience
- 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, including but not limited to reimbursement policy standards
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Colorado Residents Only: The salary range for Colorado residents is $79,700 to $142,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*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: Senior Network Contract Manager, Network Contract Manager, Network Contract, Network Management, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote