Job title: Senior Network Contract Manager – Remote – MN preferred
Company: UnitedHealth Group
Job description: At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This role with UnitedHealth Group will call on your knowledge, your energy, and your commitment to making health care work more effectively for more people. 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. As you do, you’ll discover the impact you want and the resources, backing and opportunities that you’d expect from a Fortune 4 leader.You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
- Evaluate, manage, and negotiate large national home infusion & specialty pharmacy contracts, reimbursement structure standards and other key process controls
- Forecast contract impacts to UHC lines of business, departments, health plans and Optum affiliate companies
- In coordination with UHC healthcare economics and national ancillary colleagues, manage departmental unit cost budgets, target setting, score carding, performance reporting and associated financial models
- Gain voice-of-the-market intelligence and stay up to date on industry trends, opportunities, and risks
- Develop and manage competitive network programs that achieve objectives for performance and adheres to regulatory requirements, trend management and appropriate distribution of providers while managing UHC lines of business, enterprise, and health plan expectations
- Develop, maintain, and nurture business relationships with nationally contracted providers and identify other target cost-effective, high-quality providers who help UHC achieve MBOs
- Understand and recommend deviations from standard contract language and rates
- Coordinate Quarterly Business Reviews, communicate enterprise policy, oversee large scale operations projects with Provider Advocate team, and contribute to superior Net Promoter Scores
- Coach, provide feedback, and act as a resource for others with less experience
- Work cross functionally to facilitate resolution of issues
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:
- 5+ years of experience in a network management-related role handling complex network provider negotiations with accountability for business results
- 5+ years of experience in the health care industry
- 5+ years of experience with contracting including development of product pricing and utilizing financial modeling in making rate decisions
- In-depth knowledge about infusion pharmacy and/or specialty pharmacy
- Intermediate level of proficiency with Microsoft Office Suite with the ability to create PowerPoint presentations and create pivot tables for data analysis (Outlook, Excel, Word, PowerPoint, Teams, etc.)
- Proven track record building and maintaining strong provider relationships
- Able and willing to travel up to 10% domestically
Preferred Qualifications:
- Infusion contracting experience
- Experience in performing network adequacy analysis
- Experience in fee schedule development using actuarial models
- Intermediate level of knowledge of claims processing systems and guidelines
- Knowledge of standard pharmaceutical industry reimbursement models (i.e. AWP, WAC, ASP)
- Exposure to Affordability / medical cost management concepts
- Proven excellent verbal and written communication skills
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyThe salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.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.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.
Expected salary: $89800 – 176700 per year
Location: Minnetonka, MN
Job date: Fri, 21 Feb 2025 23:50:03 GMT
Apply for the job now!