Network Contract Manager - Denver or Albuquerque
UnitedHealth Group - Centennial, CO

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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)

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.

The Network Contract Manager develops the provider network (physicians, hospitals, pharmacies, 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. 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, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties.

In this role you will be expected to:
- Assess and interpret customer needs and requirements.
- 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.

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.

Requirements:
- Undergraduate degree
- 4+ years experience in a network management-related role, such as contracting or provider services.
- In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS).
- 3+ years of experience in fee schedule development using actuarial models.
- 3+ years of experience utilizing financial models and analysis in negotiating rates with providers.
- At least an intermediate level of knowledge of claims processing systems and guidelines.
- 3+ years of experience in performing network adequacy analysis.
- 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

UnitedHealth Group - 13 months ago - save job - block
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When you work to better people’s lives, one of those lives will always be yours. We have modest goals: Improve the lives of...