Senior Network Contract Manager - Remote

Primary Responsibilities

• Analyze and evaluate payment appendices to strategize options for various contracting approaches and methodologies
• Evaluate market rates and provider performance (e.g., billing patterns; referral patterns; quality and effectiveness) in order to establish provider rates and negotiation strategies
• Explain the organization's direction and strategy to providers in order to justify methodologies, processes, policies, and procedures
• Input contract projections accurately into appropriate tools and analyze financial impact of provider contracts to achieve company goals
• Communicate proposed contractual terms with provider and negotiate mutually acceptable agreement
• Establish and manage relationships with providers to navigate operational, legal, financial and clinical matters

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.
• Knowledge of Medicare and Medicaid regulations
• Intermediate level of proficiency with MS Excel and other Microsoft Office applications

Preferred Qualification

• Experience with in vivo gene therapy COE networks

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Pay

• Salary range: $91,700 - $163,700 annually

Company Information

• 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.
• 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.