Sr Network Contract Manager - Remote

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 equitable. Ready to make a difference? Join us and start doing your life's best work.(sm)Position in this function is responsible for provider recruitment and negotiating provider agreements for UnitedHealthcare’s Empire Plan. Develops the provider network 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. Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Establishes and maintains strong business relationships with Physicians and ensures the network composition includes an appropriate distribution of provider specialties. The Sr. Network Contract Manager will also be responsible for tracking and trending out of network recruitment activity, cost savings and making recommendations on potential contracting opportunities to support provider network adequacy.If you are located in New York City; Albany, New York, upstate New York, downstate, New York and northern New Jersey, Kingston, New York, Islandia, New York or Connecticut, you will have the flexibility to work remotely as you take on some tough challengesPrimary Responsibilities:

General Job Profile

Reviews the work of others

Develops innovative approaches

Sought out as an expert

Serves as a leader/mentor

Job Scope and Guidelines

Initiate contact with providers regarding proposals, to overcome rate objections and utilize effective and efficient negotiation skills to obtain appropriate reimbursement rates

Develop and build provider relationships to facilitate current and future provider agreements

Anticipates customer needs and proactively develops solutions to meet them

Serves as a key resource on complex and/or critical issues

Forecasts and plans resource requirements

May lead functional or segment teams or projects

Functional Competencies - Evaluate/Analyze Current Contract and Market Performance

Analyze UCRT associated with products, markets, and/or providers to assess performance against budget

Demonstrate understanding of and utilize applicable financial tools (e.g., PPM; HCE's RVU/Unit tool) and reports (e.g., internal financial models; external reports) to evaluate performance of current contracts

Demonstrate understanding of contract language to assess financial and operational impact and legal implications of requested contract changes

Demonstrate understanding of competitor landscape within the market (e.g., rates; market share; product; provider networks; market intelligence; GeoAccess)

Functional Competencies - Develop/Negotiate/Support Terms of Agreement with Providers

Interact and consult with Network Pricing team to evaluate different financial arrangements and to identify and recommend

Utilize appropriate contract management systems (e.g., CLM; Contract Attachment Repository) to author and execute contracts and to access supplemental contractual documents

Communicate proposed contractual terms with provider and negotiate mutually acceptable agreement

Updates appropriate source systems within designated timeframes to ensure that requests are closed out timely

Manage Provider Relationships

Explain the organization's direction and strategy to internal partners and providers in order to justify methodologies, processes, policies, and procedures

Identify and gather information regarding provider issues to develop and/or implement strategy to resolve matter, keep manager informed of progress, or escalate issue to appropriate internal business partner

Communicate contractual and/or operational performance to providers to ensure compliance with contractual terms and protocols

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:

Bachelor’s Degree or 4 years of equivalent experience

2+ years of experience with payment methodologies (Ex. APR DRG, MS DRG, APCs, RBRVS, Per Diems)

4+ years of experience working within one or more of the following areas: Contract Management, Managed Care, and Network Management

2+ years of experience managing assignments within tight deadlines

2+ years of experience negotiating rates with providers using financial tools and reports

2+ years of proficiency in Excel & Word

Ability to travel up to 25%

Preferred Qualifications:

Experience in a matrixed environment managing key stakeholders

Experience in project management

Experience in Root Cause resolution

Proven critical thinking

Proficiency in PowerPoint

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)New Jersey, or New York Residents Only: The salary range for New Jersey, or New York residents is $85,000 to $167,300. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyAt UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.