The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This 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 5 leader.
If you reside in the state of Tennesse, you will have the flexibility to work remotely* 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 negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls with a focus on hospitals, clinics, and ancillary providers
- Forecast and plan resource requirements
- Authorize deviations from standards
In this role you will be expected to:- Demonstrate expertise in provider network functions, ability to work in a fast-paced environment
- Ability to take initiative and use problem-solving skills for issue resolution
- Work independently with little need for instruction, guidance or direction
- Must be attentive to detail, work with flexibility, and have the capability of multi-tasking to meet deadlines and deliverables
- Analytical and problem-solving skills, with a demonstrated ability to gather, understand, and evaluate information from various sources
- Ability to prioritize and manage concurrent, and occasionally, competing initiatives
*Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement.
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 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.
- Driver's License and access to reliable transportation
Preferred Qualifications:- Experience with performance-based contracts
- Intermediate level of knowledge of claims processing systems and guidelines
*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 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
