Senior Network Contract Manager - Remote

About the role

OptumHealth, part of UnitedHealth Group, is looking for a self-directed Senior Network Contract Manager to work remotely from anywhere in the U.S. The role manages contracts, cost trends, provider relationships and network growth/strategy for Optum's Centers of Excellence provider networks (transplant, cancer, congenital heart disease and VAD) through negotiations with large academic hospitals and health systems. It executes network strategies to meet client and sales goals, contracts competitive rates, evolves payment methodology and manages provider relationships.

Key responsibilities

• Analyze and evaluate payment appendices to strategize contracting approaches and methodologies
• Evaluate market rates and provider performance (billing patterns, referral patterns, quality and effectiveness) to set provider rates and negotiation strategies
• Explain the organization's direction and strategy to providers to justify methodologies, processes, policies and procedures
• Input contract projections accurately into tools and analyze the financial impact of provider contracts
• Negotiate mutually acceptable agreements with providers and explain proposed contractual terms
• Build and manage relationships with providers across operational, legal, financial and clinical matters

Required profile

• 5+ years in a network management role handling complex providers with accountability for business results
• 5+ years of experience in the health care industry
• 2+ years of provider contracting, including product pricing and financial modeling for rate decisions
• Knowledge of Medicare and Medicaid regulations
• Knowledge of Medicare RBRVS, DRGs, Ambulatory Surgery Center Groupers and similar
• Preferred: experience with high-cost cell and gene therapies, organ transplants or cancer specialties, and experience at a Fortune 500 company
• Driver's license and access to reliable transportation

Required skills

• Intermediate proficiency with MS Excel and other Microsoft Office applications

What we offer

• Salary of $91,700 - $163,700 annually for full-time employment
• Comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (subject to eligibility)
• Remote work flexibility within the U.S., subject to the Telecommuter Policy