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Optum

Senior Network Contract Manager - Remote (PA/DE preferred, working EDT)

Posted An Hour Ago
Be an Early Applicant
In-Office or Remote
Hiring Remotely in Horsham, PA
92K-164K Annually
Senior level
In-Office or Remote
Hiring Remotely in Horsham, PA
92K-164K Annually
Senior level
Manages hospital contract negotiations, provider network development, reimbursement pricing, financial modeling, performance reporting, and unit cost management. The role builds competitive provider networks, ensures contracting compliance, supports forecasting, resolves team issues, and maintains relationships with hospital executives. It requires extensive provider and health system contracting experience, financial acumen, knowledge of reimbursement methodologies, and travel within Pennsylvania and Delaware as needed.
The summary above was generated by AI
Requisition Number: 2385469
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 optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
The health care system needs to evolve even further than it has, and it has to do so at a lightning-fast pace. New models of care and networks of providers are emerging now to better serve patients and communities. And at UnitedHealth Group, we are playing a lead role. Here's where you come in. As a Senior Network Contract Manager within our network contracting team, 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. In return, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Manage hospital contract negotiations to achieve goals related to unit cost budgets, 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
  • Set team direction, resolve problems, and provide guidance to members of your team
  • Influence and/or provide input to forecasting and planning activities
  • This role is all about challenge and relationships. You'll partner with CEOs from various lines of business as we work on building effective relationships with large hospitals

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 handling complex network providers with accountability for business results
  • 3+ years of experience being in an external facing role, representing your organization with clients, vendors and/or government officials
  • 3+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
  • 2+ years of experience with health system contracting
  • Financial acumen and ability to understand financial modeling and trending
  • Must be able to work Eastern Time Zone hours
  • Willing and able to travel as needed in PA/DE (could be up to 25%)

Preferred Qualifications:
  • 3+ years of supervisory / project lead experience
  • 2+ years of experience contributing to the development of product pricing and utilizing financial modeling in making rate decisions and managing a medical cost and administrative budget
  • 2+ years of experience using financial models and analysis to negotiate rates with providers
  • Hospital contracting experience
  • Superior writing skills and ability to convey complex matters in a streamlined manner to a variety of management levels
  • Expert level of knowledge of CMS reimbursement structures, DRG methodology, Ambulatory Surgery Center Groupers, fee schedule applications, etc.
  • Solid interpersonal skills, establishing rapport and working well with others

*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.
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.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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