Manager, Provider Network Contracting

Posted Yesterday
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New Orleans, LA, USA
In-Office
92K-164K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Manages provider network contracting, unit cost budgets, financial models, pricing decisions, and network performance reporting. Develops geographically competitive provider networks, evaluates and negotiates contracts, ensures specialty distribution, and guides team members. Partners with business leaders and medical groups to manage reimbursement structures, medical costs, forecasting, and planning. Requires extensive network management, provider contracting, financial modeling, supervisory, and healthcare reimbursement expertise.
Summary Generated by Built In
Requisition Number: 2388564
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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
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 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 reside in the state of Louisiana or Mississippi, you will have the flexibility to work remotely* 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 specialties
  • Set 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 medical groups.
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 providers with accountability for business results
  • 3+ years of supervisory experience
  • 2+ years of experience contributing to the development of product pricing and utilizing financial modeling in making rate decisions and managing a medical cost and administrative budget
  • 2+ years of experience with provider contracting
  • Expert level of knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
  • Driver's License and access to reliable transportation

*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.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • 5+ years of experience in network management-related roles handling complex network providers with accountability for business results
  • 3+ years of supervisory experience
  • 2+ years of experience contributing to product pricing development and using financial modeling for rate decisions and medical cost and administrative budget management
  • 2+ years of experience with provider contracting
  • Expert-level knowledge of Medicare Resource Based Relative Value System, DRGs, Ambulatory Surgery Center Groupers, and related reimbursement methodologies
  • Valid driver's license and access to reliable transportation

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Leave & Time Off Breadth — PTO is generally described as decent or good, and many note it as a strong part of the package. Actual ability to take time off can depend on workload and team coverage.
  • Retirement Support — Offerings include a 401(k) with employer match and access to an employee stock purchase plan, which are highlighted as meaningful components of total rewards. These programs are consistently referenced among core benefits.
  • Parental & Family Support — Parental and caregiver leave, along with adoption assistance, are publicly highlighted and viewed as notable elements of the package. Availability can be role-specific, but these supports contribute to overall breadth where offered.

Optum Insights

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
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