Division of UnitedHealth Group LOOKING FOR Division of UnitedHealth Group JOB AT Senior Healthcare Provider Network Contract Manager – New Jersey

UnitedHealthcare is a company that’s on the rise. We’re expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn’t about another gadget, it’s about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life’s best work.(sm)

As a Senior Network Contract Manager, you will develop and maintain the national provider network (physicians, hospitals, ancillary groups & facilities, etc.) 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. Senior Network Contract Managers evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining solid business relationships with Hospital, Physician, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties.

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
• Assess and interpret customer needs and requirements
• Identify solutions to non-standard requests and problems
• Work with minimal guidance; seek guidance on only complex tasks
• Act as a resource for others with less experience
• Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls, establishment of relationships with large ancillary and physician groups, PHO’s, IPA’s etc.
• Utilize knowledge using a contracting database, acuity for financial models, and experience with performance-based contracting and ACO arrangements

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:

• Undergraduate degree or equivalent experience
• 3+ years of experience in a network management-related role, such as contracting or provider services
• 2+ years of experience with facility, ancillary and/or physician contracting, such as (i.e., large medical groups, hospitals, FQHC/RHC’s, Ancillary, Urgent Care, PHO’s, IPA’s, other)
• Knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)z
• Proficiency with MS Office Suite
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

• 2+ years of experience in fee schedule development using actuarial models
• 2+ years of experience utilizing financial models and analysis in negotiating rates with providers
• Experience with performance-based contracts
• Demonstrated knowledge of systems commonly used within network management such as CLM, MSPS, FIRST, IMPACT, Emptoris, NDB, etc.
• Excellent verbal and written communication skills
• Ability to multi-task
• Interpersonal skills, establishing rapport and working well with others
• Customer service skills

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with UnitedHealthcare. Let’s talk about opportunity. Start with a Fortune 5 organization that’s serving more than 85 million people already and building the industry’s singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they’re found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that’s second to none. This is no small opportunity. It’s where you can do your life’s best work.(sm)

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.