Network Contracts Manager - Ontario, CA
Company: UnitedHealth Group
Location: Ontario
Posted on: March 18, 2023
Job Description:
Optum is a global organization that delivers care, aided by
technology to help millions of people live healthier lives. The
work you do with our team will directly improve health outcomes by
connecting people with the care, pharmacy benefits, data and
resources they need to feel their best. Come make an impact on the
communities we serve as we help advance health equity on a global
scale. Here, you will find talented peers, comprehensive benefits,
a culture guided by diversity and inclusion, career growth
opportunities and your life's best work.(sm)It's a big step forward
when you realize that you've earned the trust to lead a team. Now,
let's determine just how big that step can be. Take on this
managerial role with UnitedHealth Group and you'll be part of a
team that's reshaping how provider networks evolve and how health
care works better for millions. As a 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. As you do, you'll discover the impact you want and the
resources, backing and opportunities that you'd expect from a
Fortune 6 leader.If you are located in Ontario, CA, you will have
the flexibility to work from home--and the office--at least 1 - 2
days per week--in this hybrid role* as you take on some tough
challenges.--Primary Responsibilities:
- Negotiates and support terms of agreement with Specialty and
Ancillary providers 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
- Demonstrates understanding of contract language in order to
assess financial and operational impact, including legal
implications of requested contract changes, aligned with business
objectives
- Demonstrates understanding of contract policies to ensure
compliance and consistent contracting across the Enterprise
- Demonstrates knowledge of competitive landscape within
respective market space (e.g., rates, market share, product lines,
market intelligence, GeoAccess)
- Establishes and maintains strong business relationships with
Specialty and Ancillary providers, ensuring the network composition
includes an appropriate distribution of provider specialties to
meet adequacy
- Implements and support local, regional and/or national
initiatives and directives through contracting strategies and
communication efforts
- Implements contracting strategies to support new benefit
designs and plans
- Ensures relevant contract and demographic information is
loaded, timely, accurate and consistent in applicable platform(s)
in order to support network review
- Ensure processes are consistent with CMS, state, and federal
regulations and guidelines
- Performs all other related duties as assignedYou'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 work experience
- 3+ years of experience in a network management related role,
such as contracting/recruiting or provider services
- 2+ years of experience using financial models and analysis to
negotiate rates with providers
- Proficiency with Microsoft Office applications to include Word,
Excel, Visio, PowerPoint, Smartsheet, SharePoint, Microsoft Teams,
and Outlook
- Ability to travel 10%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
- Intermediate level of knowledge of claims processing systems
and guidelines
- Working knowledge of health care reimbursement practices,
utilization management requirements, claims handling procedures,
health insurance benefit administration and risk-based
reimbursement
- Ability to solve moderately complex problems and adapt to
process variances in situations where limited standardization
exists
- Excellent written and presentation skills in order to easily
communicate to diverse audiences
- Exceptional time management and organizational skill(s) to
balance multiple priorities in a fast paced working
environmentCareers with Optum. Our objective is to make health care
simpler and more effective for everyone. With our hands at work
across all aspects of health, you can play a role in creating a
healthier world, one insight, one connection and one person at a
time. We bring together some of the greatest minds and ideas to
take health care to its fullest potential, promoting health equity
and accessibility. Work with diverse, engaged and high-performing
teams to help solve important challenges.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.
Keywords: UnitedHealth Group, Ontario , Network Contracts Manager - Ontario, CA, Executive , Ontario, California
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