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 to start Caring. Connecting. Growing together.
You get it. Everyone gets it. The health care system needs to evolve even further than it has and it has to do so quickly. New models of care and new networks of providers are emerging now to better serve patients and communities. And leaders like UnitedHealth Group are playing a lead role. Here's where you come in. As member of our network contracting team, you'll help develop and support Provider Networks and guide 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 6 leader.
Primary Responsibilities:
- Manage unit cost budgets, target setting, performance reporting and associated financial models
- Predict emerging customer needs and develop innovative solutions to meet them
- Help develop 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
Get ready for a high impact role. You'll be tasked with working in conjunction with our national clinics and hospitals to manage, collect and analyze provider data, updating and loading provider data and resolving any escalated issues with the clients.
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:
- 3+ years of experience in a network management-related role, such as contracting or provider services
- 2+ years of experience in fee schedule development using actuarial models
- 2+ years of experience using financial models and analysis to negotiate rates with providers
- 2+ years of experience in performing network adequacy analysis
- In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
- Intermediate level of knowledge of claims processing systems and guidelines
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The hourly range for this role is $28.03 to $54.95 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
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.
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