Network Contract Manager

Posted Yesterday
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Tampa, FL, USA
In-Office
73K-130K Annually
Junior
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Manages provider network contracting and risk-contracting activities for government health plan lines of business. Responsibilities include negotiating provider contracts, managing unit-cost budgets, developing financial models, analyzing network adequacy, supporting capitation execution, and ensuring competitive provider network composition. The role also involves cross-functional collaboration, problem resolution, reporting, coaching, and guidance of team members.
Summary Generated by Built In
Requisition Number: 2384557
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.
It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. Take on this managerial role with UnitedHealth Group and you'll be part of a team that's reshaping how provider networks evolve and how health care works better for millions. 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. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.
Primary Responsibilities:
  • Evaluate and negotiate contracts in compliance with company template, reimbursement structure standards and other key process controls with a concentration in FQHC/RHC's in the South Atlantic market and Government Focus provider groups
  • 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
  • Ensure that network composition includes an appropriate distribution of provider specialties
  • 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 Capitation contract execution/maintenance
  • Work effectively across lines of business and across the organization including interactions with LOB leaders, HCE, and Capitation Operations
  • Provide explanations and information to others on difficult issues
  • Coach, provide feedback and guide others
  • Get ready for some significant challenge. This is an intense, fast-paced environment that can be demanding. In addition there are some data challenges and unique problems that need to be solved related to gaps in the process

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:
  • 2+ years of experience in the health care industry
  • 2+ years of experience in a network management-related role, such as contracting, provider services, or provider data operations
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Ability to prioritize tasks and work effectively under time constraints
  • Excellent verbal and written communication skills
  • Excels in building key internal & external business relationships to meet the needs of our customers and partners

Preferred Qualifications:
  • 3+ years of experience with large provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
  • 2+ years of experience in fee schedule development using actuarial model
  • 2+ years of experience using financial models and analysis to negotiate rates with providers
  • 2+ years of experience in performing network adequacy analysis
  • Experience in health plans with a demonstrated focus on Capitation/value-based contracting

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 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

  • 2+ years of experience in the health care industry
  • 2+ years of experience in a network management-related role, such as contracting, provider services, or provider data operations
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Ability to prioritize tasks and work effectively under time constraints
  • Excellent verbal and written communication skills
  • Ability to build key internal and external business relationships
  • 3+ years of experience with large provider contracting, including product pricing development and financial modeling for rate decisions
  • 2+ years of experience in fee schedule development using an actuarial model
  • 2+ years of experience using financial models and analysis to negotiate provider rates
  • 2+ years of experience performing network adequacy analysis
  • Experience in health plans with a demonstrated focus on capitation or value-based contracting

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Leave & Time Off Breadth — Paid time off is often regarded as generous, with meaningful accrual and flexibility to use it. While practices can vary by team, the overall time-off offering stands out as a relative strength.
  • Retirement Support — A 401(k) plan with employer matching is available and generally well-regarded for supporting long-term savings. It remains valuable, though candidates should verify the current match formula.
  • Parental & Family Support — Programs such as parental leave, family medical leave, and adoption assistance are included as notable elements of the total rewards package. These resources can meaningfully support work-life balance when applicable to the role and location.

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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
Metro Manila, Philippines
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Ann Arbor, MI
Atlanta, GA
Baltimore, MD
Bengaluru, India
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Minneapolis, MN
Nashville, TN
New Delhi, India
Philadelphia, PA
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Raleigh, NC
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