Network Contract Manager - Remote - FL preferred

Posted Yesterday
Be an Early Applicant
Hiring Remotely in Tampa, FL, USA
In-Office or Remote
73K-130K Annually
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Manage government risk contracting and provider network activities, including unit cost budgets, financial modeling, rate negotiations, capitation contract execution, network adequacy, provider specialty distribution, and performance reporting. The role supports competitive, stable networks and communicates contracting status to health plan leadership while coaching others and resolving operational issues.
Summary Generated by Built In
Requisition Number: 2374525
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 more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This leadership 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 5 leader.
If you are located in Florida, 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
  • Support Government Risk Contracting Manager/Director to achieve Risk contracting goals and objectives for all Government LOB's
  • Provide day-to-day management of Risk contracting activities, including project management, problem resolution and other activities to drive to Capitation contract execution/maintenance
  • Work effectively across lines of business and across the organization including interactions with HCE, LOB Leaders, and Capitation Operations
  • Accurately and effectively communicate Government Risk contracting status to Health Plan leadership
  • 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
  • Provide explanations and information to others on difficult issues
  • Coach, provide feedback and guide others

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.
Please review the Required Qualifications and you must meet or exceed the requirements listed below to be eligible to apply to this position.
Required Qualifications:
  • 3+ years of experience in a network management-related role, such as contracting or provider services, or provider data
  • 2+ years of experience in fee schedule development using actuarial models
  • 2+ years of experience using financial models and analysis to negotiate rates with providers
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)

Preferred qualificaitions
  • 2+ years of experience in performing network adequacy analysis
  • 2+ years of experience with value-based provider incentives, which could include Accountable Care Organizations, quality incentives, shared savings/risk, or capitated agreements

*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 $72,800 - $130,000 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 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.

Skills Required

  • 3+ years of experience in a network management-related role, such as contracting, provider services, or provider data
  • 2+ years of experience in fee schedule development using actuarial models
  • 2+ years of experience using financial models and analysis to negotiate rates with providers
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • 2+ years of experience performing network adequacy analysis
  • 2+ years of experience with value-based provider incentives, including Accountable Care Organizations, quality incentives, shared savings or risk, or capitated agreements

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Parental & Family Support Paid parental leave (six weeks), paid caregiver leave (up to two weeks), Bright Horizons back-up care, and adoption assistance up to $10,000 are prominently included. Feedback suggests these family supports meaningfully aid work-life balance and are often highlighted as strengths.
  • Retirement Support A 401(k) with company match is available to all employees, including part-time staff, alongside other financial protections like disability and life insurance. Feedback suggests broad access and matching make retirement support a core pillar of the package.
  • Equity Value & Accessibility An Employee Stock Purchase Plan offers discounted company stock, with some roles also eligible for sign-on or performance bonuses. Feedback suggests the ESPP is a standout financial perk that helps employees build ownership over time.

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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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