UnitedHealth Group is hiring

Network Contract Manager - Telecommute in Houston, TX job at UnitedHealth Group, Houston

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Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

Position in this function develops 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.

Position in this function 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.

If you are located in Houston, TX, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Evaluate/analyze current contract and market performance
  • Develop/negotiate/support terms of agreement with providers
  • Manage provider relationships
  • Educate providers on the organization's processes, policies, and procedures in order to ensure provider compliance and ease of administration
  • Develop/implement/execute/support market strategies
  • Develop and/or implement contracting strategies to support new benefits designs and plans


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
  • 4+ years of experience in a network management-related role, such as contracting or provider services
  • 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:

  • 3+ years of experience in fee schedule development using actuarial models
  • 3+ years of experience using financial models and analysis to negotiate rates with providers
  • Experience working with Medicare Advantage Plans
  • Knowledge of network adequacy analysis
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Intermediate level of knowledge of claims processing systems and guidelines


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 WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.


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.


Job country: United States

City: Houston

Category: Business Operations Specialists, All Other

Location: Houston, TX, United States

Job posted 2022-06-04

This job is expired

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