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 7 leader.
This position develops the provider network (physicians, hospitals, ancillary groups & facilities, etc.) for VA Community Care Network (VACCN) 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; and establishes and maintains solid business relationships with Hospital, Physician, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties.
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 striving to ensure accuracy.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:- Manage unit cost budgets, target setting, performance reporting and associated financial models
- Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance, trend management and appropriate distribution of provider specialties
- Evaluate and approve contracts in compliance with company templates, reimbursement structure standards and other key process controls
- Review work performed by others and provide recommendations for improvement
- Forecast and plan resource requirements
- Authorize deviations from standards
- Reviews the work of others
- Develops innovative approaches
- Sought out as expert
- Serves as a leader/ mentor
- Leading a team of Contract Managers
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 health care network management-related role handling complex network providers with accountability for business results
- 5+ years of experience in the health care industry
- Project management experience
- In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
- In-depth knowledge of Government Programs
Preferred Qualifications: - 3+ years of supervisory experience
- 2+ years of experience with health care provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
- Experience with VA Community Care (VACCN) or Tri Care
*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.
