573474: Contract Manager, Skilled Nursing Facilities Network - Waltham, MA - Full-time / Part-time

Expanding access to affordable, high quality health care starts here. Healthcare contracting and accurate pricing will have more of an impact on every patient, provider and consumer as this industry continues to prove itself always changing and evermore challenging, and your opportunity to influence that outcome in a daring and bold fashion is here. UnitedHealth Group is like no place you've ever seen or worked before, with the chance to grow and develop your contributions to ensure the healthcare contracts are priced accurately and fairly for all involved. Go further to heal the healthcare system than you'd ever imagined possible. 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)

UnitedHealth Networks, part of the UnitedHealth Group family of companies, is now looking for a seasoned Contract Manager for our team in Waltham MA. You will be responsible for managing contractual relations for Skilled Nursing Facilities throughout Massachusetts. Reporting to the Director of Network Programs, the Contract Manager develops the provider network 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. 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 providers, and ensuring the network composition includes an appropriate distribution of provider specialties. 

Primary Responsibilities:

• 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

Required Qualifications:

• Undergraduate degree or equivalent experience


• 3+ years of experience in the healthcare and/or health insurance industries


• 3+ years of experience in a network management-related role handling complex network providers with accountability for business results


• Expert level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.


• 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


• Ability to manage multiple projects


• Ability to work effectively and congenially with employees at all levels; objective, collaborative approach; relationship builder who strives to build partnerships

Preferred Qualifications:

• Experience specific to Skilled Nursing Facilities


• 2+ years of experience in contributing to the development of product pricing and utilizing financial modeling in making rate decisions


• 2+ years of experience with provider contracting; preferably working with hospital systems and large medical groups

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

Diversity creates a healthier atmosphere: 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: contract, contracting, relations, provider, health, healthcare, insurance, managed care, skilled nursing facility, Waltham, Boston, MA