The Role
Manage provider network contracts, reimbursement negotiations, unit cost budgets, financial models, pricing decisions, and network performance reporting. Develop competitive provider networks, authorize contract deviations, review team work, forecast resources, and ensure compliance with reimbursement standards. The role requires extensive healthcare and network management experience, provider contracting expertise, knowledge of reimbursement methodologies, advanced Microsoft Office and SharePoint proficiency, and availability during CST business hours.
Summary Generated by Built In
Requisition Number: 2390126
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 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 6 leader.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
In this role, you will need to be able to thrive in a demanding, intense, fast-paced environment. In addition, you'll be driving some complex negotiations while focusing on ensuring accuracy.
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:
*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 to $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 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.
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 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 6 leader.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
- Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance, trend management and appropriate distribution of provider specialties
- Manage unit cost budgets, target setting, performance reporting and associated financial models
- Review work performed by others and provide recommendations for improvement
- Forecast and plan resource requirements
- Authorize deviations from standards
In this role, you will need to be able to thrive in a demanding, intense, fast-paced environment. In addition, you'll be driving some complex negotiations while focusing on ensuring accuracy.
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
- 5+ years of experience in the health care industry
- 2+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
- In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
- Proven knowledge of provider reimbursement methodologies
- Advanced level of proficiency using MS Office Suite (Word, Excel, Outlook, PowerPoint) and SharePoint
- 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
- Ability to work CST hours of Monday - Friday 8:00 am - 5:00 pm
*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 to $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 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 a network management-related role handling complex network providers with accountability for business results
- 5+ years of experience in the health care industry
- 2+ years of experience with provider contracting, including product pricing development and financial modeling for rate decisions
- In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, and Ambulatory Surgery Center Groupers
- Proven knowledge of provider reimbursement methodologies
- Advanced proficiency using Microsoft Office Suite, including Word, Excel, Outlook, and PowerPoint, and SharePoint
- Excellent verbal and written communication skills, including the ability to communicate complex information clearly
- Ability to work CST hours Monday through Friday, 8:00 a.m. to 5:00 p.m.
Optum Compensation & Benefits Highlights
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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.
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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.
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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.
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The Company
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
