Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)
The Manager, Physician Contracting develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers at least 50% of the time. Complex providers may include, but are not limited to large medical groups and ancillary providers, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are often customized.
The Manager, Physician Contracting evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls.
- Anticipate customer needs and proactively develop solutions to meet them
- Works independently and requires high level of judgment and discretion
- Serve as a key resource on complex and/or critical issues
- Solve complex problems and develop innovative solutions
- Perform complex conceptual analyses
- Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development
- Review work performed by others and provide recommendations for improvement
- Forecast and plan resource requirements
- May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management
- Provide explanations and information to others on the most complex issues
Undergraduate degree or equivalent experience
3+ years experience in a healthcare network management-related role (contracting, provider relations, provider servicing, etc.) handling complex network providers with accountability for business results
Experience and comprehensive level of negotiating skills with successful track record negotiating contracts with individual or complex provider systems or groups
2+ years experience in contributing to the development of product pricing and utilizing financial modeling in making rate decisions
2+ years managing and/or leading a team
Advanced level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
Strong customer service skills
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others, including but not limited to reimbursement policy standards
Strong interpersonal skills, establishing rapport and working well with others
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)
*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: Network, Contracting, Manager, Medicare, DRGs, Ambulatory, Provider, Jackson, MS, Mississippi, Birmingham, AL, Alabama, Metairie, LA, Louisiana