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 with hospital, ancillary and physician providers in compliance with company templates, reimbursement structure standards, established financial targets... more details
At UnitedHealthcare, were 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.
The more you do, the more you learn. As you learn you find new doors opening that challenge you to bring your best. As a participant in our network management team, youll guide the development and support of Provider Networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting. The market has a Commercial, Medicare Advantage and Managed Medicaid product which enables a wide variety of strategic opportunities for creative projects and self-growth. Youll discover the impact you want and the resources, backing and opportunities that youd expect from a Fortune 6 leader.
Youll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
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 with hospital, ancillary and physician providers in compliance with company templates, reimbursement structure standards, established financial targets and other key process controls
- Ensure that network composition includes an appropriate distribution of provider specialties
- Have confidence in leading groups and handling difficult discussions and making decisions with facts and data you have accumulated
- Be responsible for follow up items and managing project plans either on your own or with a cross functional team
- Primary focus on physician contracting
Get ready for a high impact role. The support you feel all around you will enable you to do what you do with energy, integrity, and confidence. So, take the first step in what is sure to be a fast paced and highly diversified career.
Youll 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 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 managing complex meetings and/or projects
- 2+ years of experience with provider contracting
- Financial acumen and ability to understand financial modeling and trending
- Superior writing skills and ability to convey complex matters in a streamlined manner to a variety of management levels
- Solid interpersonal skills, establishing rapport and working well with others
Preferred Qualifications:
- 2+ years of demonstrated ability to manage and lead individuals to achieve targeted, positive outcomes and results
- In-depth knowledge of Medicare Diagnostic Related Group (DRG)
- Experience using financial models and analysis to negotiate rates with providers
- Knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
- Intermediate level of knowledge of claims processing systems and guidelines
- Advanced competency of Excel, including pivot tables
- Advanced competency of other Microsoft Office Suite (Outlook, Word, PowerPoint) and SharePoint
*All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $88,000 to $173,200 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al 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, youll 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.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.
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.