Sr Healthcare Network Contract Manager -- Westerville, OH (385869)
UnitedHealth Group - Westerville, OH

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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 Senior Network Contract Manager develops the provider network (physicians/physician groups, hospitals, 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. Senior 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/Physician Groups and ensuring the network composition includes an appropriate distribution of provider specialties. In this role you will be expected to:

  • Anticipate customer needs and proactively develop solutions to meet them.
  • Serve as a key resource on complex and/or critical issues.
  • Solve complex problems and develop innovative solutions.
  • Perform complex conceptual analyses.
  • Review work performed by others and provide recommendations for improvement.
  • Forecast and plan resource requirements.
  • Authorize deviations from standards.
  • May lead functional or segment teams or projects.
  • Provide explanations and information to others on the most complex issues.
  • Motivate and inspire other team members.
Familiar with Central Ohio Market.

Qualifications

Requirements:
  • Undergraduate degree preferred or equivalent experience.
  • 5+ years experience in a network management-related role handling complex network providers with accountability for business results.
  • 5+ years experience in the health care industry.
  • 2+ years experience in contributing to the development of product pricing and utilizing financial modeling in making rate decisions
  • Expert level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
  • 2+ years experience with provider contracting.
  • Strong customer service skills
  • 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.
  • Strong interpersonal skills, establishing rapport and working well with others.
UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Together, we�re removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.

Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.

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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