Healthcare Provider Network Contract Manager - Veterans - East Region

Employer
UnitedHealth Group
Location
Chesterland, Ohio
Posted
Apr 07, 2021
Closes
Apr 09, 2021
Ref
dafe81408f60
Sector
Law
Organization Type
Corporate
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)

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 7 leader.

Be a part of UnitedHealth Group's support of our Veteran's Affairs - Customer Care Network (VACCN), as we partner with the VA to provide care for those veterans to access our network of providers to provide medical care, dental care, pharmacy, as well as continuity of care for over 6 million veterans. This a hybrid position where you will be negotiating new and existing contracts for VACCN providers, as well as providing ongoing provider support through education, training and claims management. Here's where you come in - you'll use your end to end issue resolution and relationship building skills to 'Make it Simple, Make it Right, and Make a Difference' for those we serve.

If you are located in the Eastern U.S., (Eastern Time Zone) you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:


  • Negotiate new and existing contracts for hospitals, physicians, and ancillaries for the Veterans Affairs Community Care Network

  • Collaborate with the Provider Operations team to resolve any issues they might incur

  • Document contracting progress via VA Contracting Tools and attend internal meetings to report progress to key stakeholders

  • Research and resolve data load issues, demographic updates, and contract related requests for assigned work items

  • Attend JOCs/Ops meetings with Network Management when requested

  • Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management

  • Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls

  • Provide explanations and information to others on difficult issues

  • Coach, provide feedback and guide others



In this role, relationship building, project facilitation, claims knowledge, and advocacy are key.

Get ready for some significant challenge. This is an intense, fast-paced environment that can be demanding. In addition there are some data challenges and unique problems that need to be solved related to gaps in the process.

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:


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

  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)

  • 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

  • 3+ years of experience in performing network adequacy analysis

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders



Preferred Qualifications:


  • Undergraduate degree

  • VA / Veterans / Military / TriCare / TriWest contracting experience



Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 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 wherever 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)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

Job Keywords: Healthcare Provider Network Contract Manager, Veterans, Healthcare, Managed Care, Hospital Contracting, Physician Contracting, Ancillary Contracting, Facility Contracting, Provider Network, Network Development, Provider Services, Contract Negotiating, Network Management, Accountable Care Organization (ACO), VA, Atlanta, GA, Georgia, Tampa, FL, Florida, Washington, DC, District of Columbia, New York, NY, Cleveland, OH, Ohio, Philadelphia, PA, Pennsylvania, Telecommute, Telecommuter, Telecommuting, Remote, Work from home, Work at home

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