Network Contract Manager - Remote
UnitedHealth Group - San Antonio, TX
posted 2 days ago
About the position
Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together. 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. Attention to detail, problem solving, and establishing and maintaining solid business relationships are crucial for success in this role. Network Contract Managers support Enterprise Contracting projects as assigned and require research, critical thinking, and working with strict deadlines. Responsibilities also include establishing and maintaining solid business relationships with internal Senior Leadership, Market Partners as well as Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
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
- 3+ years of experience in a network management-related role, such as contracting or provider services
- 3+ years of experience utilizing financial models and analysis in negotiating rates with providers
- 3+ years of experience in performing network adequacy analysis
- Proven intermediate level of knowledge of claims processing systems and guidelines
Nice-to-haves
- Proven in-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
- 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 from others
- Demonstrated familiarity with fee schedule development using actuarial models
- Proven solid interpersonal skills, establishing rapport and working well with others
- Proven solid customer service skills
- Demonstrated foundational level of knowledge of claims processing systems and guidelines
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
