Impress employers and recruiters.
Choose from hundreds of resume examples.

Target Resume Now

About the Role

Network Contract Managers develop and maintain a geographically competitive and stable provider network. They evaluate and negotiate contracts, ensuring compliance with company standards and achieving cost performance objectives. This role aims to produce affordable and predictable products for customers and business partners, while maintaining appropriate provider distribution and specialty representation.

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, reimbursement methodologies and rates in compliance with company templates, reimbursement structure standards and other key process controls
Manage unit cost, target parameters, performance reporting and associated financial models
Ensure that network composition includes an appropriate distribution of provider and specialties and overall recruitment and contracting to ensure network adequacy
Work with internal contacts to implement regulatory requirements impacting provider contracts (state specific changes to state published rates, coding, new services and requirements)
Maintain existing network contracts and any contracting events that occur during the term of the agreement while generating savings opportunities for affordability initiatives
Coordinate high profile negotiations, build and nature trusted relationships with providers and internal state holders
Engage facility and hospital providers and any internal resources to resolve issues related to contract administration
Provide explanations and information to others on difficult issues

Requirements

2+ years of experience in a network management-related role, such as contracting or provider services
Experience utilizing financial models and / or financial analysis for the purpose of negotiating rates with providers or to meet other business needs
Experience in performing network adequacy analysis
Knowledge of Medicaid and/or Medicare
Intermediate level of knowledge of claims processing systems and guidelines
Proven 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
Driver’s License and access to reliable transportation
Must pass a drug test before beginning employment

Skills

Payment Appendix and fee schedule development
New York Medicaid services and reimbursement methodologies
Behavioral Health provider experience
Facility/Hospital contracting experience
Knowledge of the NY/Northeast market
Proven sound interpersonal skills, establishing rapport and working well with others
Proven sound customer service skills

Location

Work Type

Remote
Full-time

Experience Level

2+ years

Salary/Compensations

$72,800 - $130,000 annually

Benefits

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution

About the Company

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.
The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.
Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.
Come make an impact on the communities we serve as you help us advance health optimization on a global scale.
Join us to start Caring. Connecting. Growing together.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.
We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life.
Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.
We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Equal Opportunity

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.