Get ready for some significant challenge. This is an intense, fast-paced environment that can be demanding. In addition, there are some data challenges and unique problems that need to be solved related to gaps in the process.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Preference for those residing in California.
Potential for 10% of travel.
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 and trend management
- Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
- Ensure that network composition includes an appropriate distribution of provider specialties
- Provide explanations and information to others on difficult issues
- Coach, provide feedback and guide others
- Work with internal business partners on managing and addressing provider issues
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:- 4+ years of experience in a network management-related role, such as contracting or provider services
- 3+ years of experience using financial models and analysis to negotiate rates with providers
- 3+ years of experience in performing network adequacy analysis
- 2+ years of experience in fee schedule development using actuarial models
- Intermediate level of knowledge of Medicare Resource Based Relative Value System (RBRVS)
- Intermediate level of knowledge of claims processing systems and guidelines
Preferred Qualifications:- Undergraduate degree
- Experience and knowledge with using tools and platforms such as Microsoft Copilot, Teams, OneNote, Salesforce etc
- Commercial and Medicare line of business experience
- Ability to manage competing priorities and remain organized
*All Telecommuters 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 $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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.
