Healthcare Provider Network Contractor job at UnitedHealth Group, Houston

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)

The health care system needs to evolve even further than it has, and it must 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 as the nation’s largest health insurance company, UnitedHealthcare is playing a lead role. Here's where you come in. As a network contract manager within our network contracting team, you will help develop and support provider networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting. In return, you'll discover the satisfaction of being part of one of the leading teams at UnitedHealthcare while realizing success by achieving the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader. 

A day in the life of a Network Contract Manager
While no two days in the life of a Network Contract Manager are the same, your day is likely to include:   requesting and reviewing financial analysis, negotiating contracts, responding to provider contractual inquiries, resolving complex contractual issues, developing the budget of future contract renewals for your assigned providers, leading/participating in strategy calls, holding joint operating committee meetings with health systems, recruiting targeted providers to fill specific access needs, completing ad hoc projects to meet national and/or local initiatives.

Primary Responsibilities:

• Develop the provider network (physicians, hospitals, and ancillary groups, 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 
• Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
• Establish and maintain strong business relationships with Hospital, Physician, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties.
• Provide explanations and information to others on a multitude of issues

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 work equivalent experience
• 1+ years of experience in a network management-related role handling complex network providers with accountability for business results
• 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
• 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 Qualification:

• Ability to problem solve complex issues and unique situations

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)

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.