The Network Contract Manager develops the provider network 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.
Network Contract Managers evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with providers and ensuring the network composition includes an appropriate distribution of provider specialties
This role is located in our Iselin, NJ office.
- Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
- Ensure that network composition includes an appropriate distribution of provider specialties
- Manage unit cost budgets, target setting, performance reporting and associated financial models
- Provide explanations and information to others on difficult issues
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.
- 3+ years of experience in a network management-related role, such as contracting or provider services
- 2+ years negotiation experience
- 2+ years working with Medicare Resource Based Relative Value System (RBRVS)
- At least an intermediate level of proficiency with MS Excel
- Strong communication and presentation skills
- Strong relationship building skills with clinical and non - clinical personnel
- Demonstrated ability to interact with medical staff, peers, and internal company staff at all levels
- Ability to solve process problems crossing multiple functional areas and business units
- Strong problem - solving skills; the ability to analyze problems, draw relevant conclusions, and devise and implement an appropriate plan of action
- Good business acumen, especially as it relates to Medicare Risk and Quality
Medical / clinical background highly desirable
- Understanding of Accountable Care Organizations and CPC+ programs
- Value Based Contracting experience
- Familiarity with the New Jersey Provider Community
- 3+ years of experience in performing network adequacy analysis
- Undergraduate or higher level degree
- Strong interpersonal skills, establishing rapport and working well with others
Creating and fine tuning provider networks helps improve access to health care for millions. It's an outstanding opportunity to have more meaning and purpose in your career. Join us. Find out how you can start doing your life's best work.(sm)
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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)
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 Contract Manager, Provider Network Manager, Contractor - Healthcare Network, Physician Healthcare Contractor, Iselin. NJ, New Jersey