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)
You get it. Everyone gets it. The health care system needs to evolve even further than it has and it has to do so quickly. New models of care and new networks of providers are emerging now to better serve patients and communities. And leaders like UnitedHealth Group are playing a lead role. Here's where you come in. As member of our network contracting team, you'll help develop and support Provider Networks and guide 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.
If you are located in Ohio, Indiana or Kentucky, you will have the flexibility to telecommute* as you take on some tough challenges.
- Manage unit cost budgets, target setting, performance reporting and associated financial models
- Predict emerging customer needs and develop innovative solutions to meet them
- Help develop 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
- Ensure that network composition includes an appropriate distribution of provider specialties
Get ready for a high impact role. You'll be tasked with working in conjunction with our national clinics and hospitals to manage, collect and analyze provider data, updating and loading provider data and resolving any escalated issues with the clients.
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.
- 2+ years of experience in a network management-related role, such as contracting or provider services or healthcare billing
- Knowledge and experience working with physician per unit reimbursement methodology such as the Medicare Physician Fee Schedule
- Intermediate level of knowledge of claims processing systems and guidelines
- 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
- Undergraduate degree
- 2+ years of experience in fee schedule development using actuarial models
- 2+ years of experience using financial models and analysis to negotiate rates with providers
- 2+ years of experience in performing network adequacy analysis
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: Network Contractor, contract, network, negotiate, negotiation, Telecommuter, Telecommuting, Work from Home, Remote, Cleveland, OH, Ohio, Indianapolis, IN, Indiana, Louisville, KY, Kentucky