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 Network Contract Manager develops the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) 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 Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties.
This role supports and contracts with the physician network in Georgia for all lines of business. The role is office based in Atlanta, GA.
- Anticipate customer needs and proactively develop solutions to meet them
- Serve as a key resource on complex and/or critical issues
- Forecast and plan resource requirements
- May lead functional or segment teams or projects
- 4+ years of experience in the health care industry
- 3+ years of experience in a network management-related role handling complex network providers with accountability for business results
- 2+ years of experience with provider contracting
- Expert level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
- 2+ years of experience using data analysis skills; ability to construct strategy from the provider data
- 2+ years of experience in contributing to the development of product pricing and utilizing financial modeling in making rate decisions
- Strong customer service skills
- Excellent verbal and written communication skills
- Strong interpersonal skills
- Undergraduate or higher level degree
- Location is Atlanta, GA.- Market covered is state of GA.
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 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: 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 Contractor, Healthcare, Contracting, Account Manager, Negotiation, Business Development, Manager, Consultant, Atlanta, GA, Georgia