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Hours Full-time, Part-time
Location Orlando, FL
Orlando, Florida

About this job

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)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.
 
Primary Responsibilities:

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

Requirements

Required Qualifications:

Undergraduate degree or equivalent experience
1+ 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
2+ years of experience utilizing financial models and /or financial analysis for the purpose of negotiating rates with providers or to meet other business needs
At least an intermediate level of knowledge of claims processing systems and guidelines
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.
Preferred Qualifications:

Strong interpersonal skills, establishing rapport and working well with others
Strong customer service skills
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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
 
 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: network management, contracting or provider services, Medicare reimbursement methodologies, Resource Based Relative Value System, financial models, financial analysis, claims processing systems and guidelines, remote, work from home, telecommuting, telecommuter, telecommute, Florida, Orlando, FL