Address
Form of work
SalaryDevelops the provider network (physicians, hospitals, pharmacies, 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.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
- Establishes and maintains solid business relationships with hospital, physician, pharmacy, or ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties
- Assesses and interprets customer needs and requirements
- Identifies solutions to non-standard requests and problems
- Solves moderately complex problems and/or conducts moderately complex analyses
- Works with minimal guidance; seeks guidance on only the most complex tasks
- Translates concepts into practice
- Provides explanations and information to others on difficult issues
- Coaches, provides feedback, and guides others
- Acts as a resource for others with less experience and promotes positive work environment
- Field-based; on-site visits and meetings with providers
- Conduct auditing for operations including mobile and clinical facilities to evaluate compliance with applicable regulatory requirements including OSHA and ADA
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 handling complex network providers with accountability for business results
- 3+ years of experience with direct provider contracting, including facility, physician, and ancillary providers
- Experience with client-facing responsibilities, including issue resolution and contract negotiations
- Experience performing network adequacy analysis
- Intermediate level of knowledge of claims processing systems and guidelines
- Understanding of network adequacy analytics and how to prioritize the work based on data
- MedNet experience
- Knowledge and understanding of military protocol
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves 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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
