4 days old

Network Contract Manager - Manhattan or Long Island, NY - 928448

Manhattan, NY 10007
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  • Job Code
    928448

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)

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The Network Contract Manager develops the provider network (physicians, ancillary groups & hospitals, 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 and Ancillary Providers, and ensuring the network composition includes an appropriate distribution of provider specialties.

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This role contracts with Providers and Hospitals for the Empire Plan, and so it is a highly visible position. The office location is One Penn Plaza in NYC or Islandia in Long Island, NY.

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Primary Responsibilities:

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  • Assess and interpret customer needs and requirements
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  • Identify solutions to non-standard requests and problems
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  • Solve moderately complex problems and/or conduct moderately complex analyses
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  • Work with minimal guidance; seek guidance on only the most complex tasks
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  • Provide explanations and information to others on difficult issues
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  • Act as a resource for others with less experience
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Youll 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.

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Required Qualifications:

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  • Undergraduate or higher level degree
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  • 4+ years of experience in a network management-related role, such as contracting or network development; with hospitals and large provider groups including Value Base Contracting
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  • In-depth knowledge of Physician contracting
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  • In-depth knowledge of Medicare reimbursement methodologies (i.e. Resource Based Relative Value System (RBRVS)
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  • Proficient in Microsoft Word and Excel
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  • 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
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Preferred Qualifications:

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  • 3+ years of experience in fee schedule development using actuarial models
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  • 3+ years of experience utilizing financial models and analysis in negotiating rates with providers and hospitals
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  • 3+ years of experience in performing network adequacy analysis
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  • At least an intermediate level of knowledge of claims processing systems and guidelines
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  • Familiar with the NY Provider Market
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  • Excellent verbal and written communication skills
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  • Proven interpersonal skills, establishing rapport and working well with others
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  • Proven customer service skills
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Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

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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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Network Contract Manager, Provider Network Contractor, Medicare, Network Management, Contracting, Analysis, Claims Processing, Manhattan, Long Island, NY, New York

Posted: 2021-06-10 Expires: 2021-07-10

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Network Contract Manager - Manhattan or Long Island, NY - 928448

UnitedHealth Group
Manhattan, NY 10007

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