Senior Network Contract Manager

Primary Responsibilities

• Evaluate and negotiate provider contracts in compliance with company templates, reimbursement methodologies, and established process controls
• Draft, execute, and manage Single Case Agreements, coordinating closely with clinical teams and provider partners
• Manage unit cost budgets, target setting, performance reporting, and associated financial models
• Collaborate with internal and external stakeholders to execute, implement, and maintain provider contracts
• Partner with configuration and claims teams to ensure accurate contract setup and correct claims payment
• Support the development of geographically competitive, broad-access provider networks that meet unit cost, trend management, and specialty distribution objectives
• Forecast and plan resource requirements
• Authorize deviations from standards

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 Capitation, PMPM, Fee For Service, Medicare Resource Based Relative Value System (RBRVS)

Pay

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.

Benefits

We offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).

About the Role

The role with Optum 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.