The health care system needs to evolve even further than it has and it has to do so at a lightning fast pace. New models of care and networks of providers are emerging now to better serve patients and communities. And at UnitedHealth Group, we are playing a lead role. Here's where you come in. As a network manager within our network contracting team, you'll guide the development and support of provider networks as well as unit cost management activities through financial and network pricing modeling, analysis and reporting. In return, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader.
If you are located in Tennessee, you will have the flexibility to telecommute* as you take on some tough challenges. Primary 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 in compliance with company templates, reimbursement structure standards and other key process controls
- Ensure that network composition includes an appropriate distribution of provider services
- Contribute to setting team direction, resolve problems and provide guidance to members of your team
- Influence and/or provide input to forecasting and planning activities
This role is all about challenge and relationships. You'll partner with CEO's from various lines of business as we work on building effective relationships with large health systems.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:
- Undergraduate degree or equivalent experience
- 5+ years of experience in a network management-related role handling complex network providers with accountability for business results
- 2+ years of experience contributing to financial modeling in making rate decisions and managing a medical cost and administrative budget
- Intermediate level of knowledge of Medicare, DRGs, Ambulatory Surgery Center Groupers, etc.
- 2+ years of experience with hospital contracting
- Product pricing experience
- Ancillary contracting
- Proficient in Tenncare regulatory requirements and reimbursement methodologies
- Skilled in negotiating value based performance incentive programs
- Conversant in hospital clinical performance measures
- Experienced in developing and maintaining high performance network experience (tiered, narrowed, and/or ACO products)
- Knowledgeable of Resource Based Relative Value System (RBRVS) methodology
Creating and fine tuning provider networks helps improve access to health care for millions. It's an outstanding opportunity to have more meaning and purpose in your career. Join us. Find out how you can start doing your life's best work.(sm)Careers with UnitedHealthcare.
Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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: Healthcare, health care, Contracting, Account Manager, Negotiation, Business Development, Manager, Consultant, Network Contract Manager, Remote, Tennessee, Nashville, Knoxville, Hospital Contracting, Telecommute