Manager, Provider Network Contracting - Remote

Requisition Number: 2386234
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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
The opportunity. As a Manager within our Network Contracting team, you will lead physician and facility contracting strategies that strengthen network access, affordability, stability and provider performance. You will oversee complex negotiations across hospital systems, ambulatory facilities, independent and employed physician groups, and other high-impact provider organizations. The role combines market strategy, contract development, financial analysis, relationship management and people leadership, with accountability for delivering contracting outcomes that support business, network and medical cost objectives.
How you will make an impact. You will serve as a senior contracting partner to internal leaders and external provider executives, translating market needs and financial insights into actionable negotiation strategies. You will guide your team through the full contracting lifecycle, from opportunity assessment and negotiation planning through execution, implementation and ongoing contract performance management.
Work arrangement. You will enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:

• Lead the development and execution of physician and facility contracting strategies aligned with market affordability, network access, product and growth objectives
• Own and direct complex negotiations with hospitals, health systems, ambulatory surgery centers, ancillary facilities, independent physician associations, large medical groups and other physician organizations
• Evaluate, structure and negotiate contract terms using approved company templates, reimbursement standards and process controls, including fee schedules, case rates, per diems, DRG-based methodologies, RBRVS-based physician reimbursement, ASC groupers and other value-oriented arrangements
• Develop negotiation positions and contract recommendations using financial modeling, unit cost analysis, utilization trends, competitive intelligence, provider performance information and total cost-of-care considerations
• Assess the financial and network impact of proposed rate changes, contract provisions, renewals, amendments, terminations and new provider arrangements; clearly communicate risks, tradeoffs and recommendations to leadership
• Manage physician and facility unit cost budgets, affordability targets, forecasts, savings commitments, performance reporting and associated financial models
• Guide the development and maintenance of geographically competitive, broad-access and stable physician and facility networks that meet specialty, service-area, product and regulatory requirements
• Identify network gaps, concentration risks and contracting opportunities across physician specialties, hospitals and facility types; establish action plans to improve network adequacy and market competitiveness
• Build and maintain effective executive-level relationships with hospital and health-system leaders, facility administrators, physician group executives and other key provider stakeholders
• Lead contract issue resolution and escalation activities involving reimbursement, contract interpretation, implementation, operational performance, network disruption and provider relationship concerns
• Partner cross-functionally with network analytics, pricing, finance, legal, medical economics, operations, claims, product, sales and market leadership to ensure contracts are financially sound, operationally executable and aligned with business priorities
• Ensure accurate and timely transition of executed agreements to implementation teams, including clear documentation of negotiated terms, effective dates, reimbursement exhibits and operational requirements
• Monitor post-implementation contract performance and provider results; initiate corrective action or renegotiation when outcomes do not align with contractual, financial or network expectations
• Set team direction, establish priorities, coach contracting professionals, resolve complex problems and promote consistent use of negotiation discipline, documentation and governance processes
• Influence forecasting, planning and market strategy by providing leadership with clear insights on provider dynamics, contracting risk, network performance and emerging physician and facility trends
• Leadership and Relationship Expectations
• Create a high-accountability team culture centered on preparation, disciplined negotiation, timely execution, sound judgment and measurable business results
• Provide hands-on coaching for complex physician and facility negotiations, including strategy development, financial positioning, executive presentations and escalation planning
• Represent the organization credibly with provider executives and internal senior leaders, balancing relationship stewardship with affordability, access and contract compliance objectives
• Develop team capability in reimbursement methodologies, financial analysis, market intelligence, contracting systems and end-to-end contract management

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 network management or provider contracting with direct responsibility for complex physician and facility providers and accountability for business results
• 3+ years of supervisory or people leadership experience
• 2+ years of direct provider contracting experience, including facility contracting and physician or medical group negotiations
• 2+ years of experience contributing to product pricing, using financial modeling to support rate decisions, and managing medical cost and administrative budgets
• Demonstrated experience developing negotiation strategies, evaluating contract economics and leading agreements from initial assessment through execution and implementation
• Experience interpreting financial, utilization, network and market data and translating findings into clear contracting recommendations
• Advanced knowledge of provider reimbursement methodologies, including Medicare RBRVS, DRGs, ambulatory surgery center groupers, fee schedules, case rates, per diems and related payment structures
• Demonstrated ability to manage competing priorities, lead through ambiguity and influence internal and external stakeholders without direct authority
• Driver's license and access to reliable transportation

Preferred Qualifications:

• Experience negotiating with hospital systems, large physician organizations, ambulatory facilities or other complex provider entities
• Experience with value-based, performance-based or total cost-of-care contracting arrangements
• Working knowledge of contract implementation, provider data, claims operations, network adequacy and provider directory dependencies
• Proven solid executive communication, presentation, relationship management and conflict-resolution skills

What Success Looks Like
Success in this role means delivering well-prepared, financially sound physician and facility agreements; maintaining stable and accessible networks; achieving unit cost and affordability commitments; strengthening provider relationships; reducing contract implementation risk; and developing a team capable of managing increasingly complex negotiations.
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.