Associate Network Contractor

Optum 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.

About the role

UnitedHealth Group is playing a lead role in the formation of new, effective provider networks. As a member of our network contracting team, you'll help develop and support Provider Networks and guide unit cost management activities through financial and network pricing modeling, analysis and reporting. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Responsibilities

• Supports the development of the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners
• Manage unit cost budgets, target setting, performance reporting and associated financial models
• Predict emerging customer needs and develop innovative solutions to meet them
• Help develop geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
• Evaluate and support contract negotiations in compliance with company templates, reimbursement structure standards and other key process controls
• Ensure that network composition includes an appropriate distribution of provider specialties
• Use existing procedures and facts to solve routine problems or conduct routine analyses
• Work in conjunction with our national clinics and hospitals to manage, collect and analyze provider data, updating and loading provider data and resolving any escalated issues with the clients

Requirements

• High School diploma/GED
• 1+ years of experience in a network management-related role, such as contracting or provider services
• 1+ years of experience in fee schedule development using actuarial models
• 1+ years of experience using financial models and analysis to negotiate rates with providers
• 1+ years of experience in performing network adequacy analysis
• At least an intermediate level of knowledge of claims processing systems and guidelines
• Advanced Proficient skillset in Microsoft Excel; ability to create pivot tables, work with large data, create formulas, de-dupe, etc.

Preferred Qualifications

• Undergraduate degree
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)

All telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

Pay

The hourly pay for this role will range from $24.00 to $43.00 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, and certifications. We comply with all minimum wage laws as applicable.