Network Contract Manager Jobs in California (NOW HIRING)

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Network Contract Manager will manage performance targets, reporting, and financial models while building strong, geographically competitive networks that meet organizational goals. You'll negotiate provider contracts, ensure balanced network composition, and drive growth through strategic forecasting and gap analysis. This position also involves hosting Joint Operating Committee meetings, educating accounts on compliance and best practices, and collaborating across departments to deliver creative solutions. If you're self-motivated, relationship-driven, and ready to make an impact, this is the opportunity for you!

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Manage performance target setting, performance reporting and associated financial models relative to provider network contracting
• Guide development of geographically competitive, broad access, stable networks that achieve objectives
• Evaluate, understand, and negotiate provider contracts in compliance with company templates, reimbursement structure standards and other key process controls
• Ensure that network composition includes an appropriate distribution of provider specialty types
• Influence and/or provide input to forecasting and planning activities for network growth
• Establish and maintain strong business relationships with assigned providers and internal partners
• Research provider footprint and evaluate for gap filling
• Host Joint Operating Committee (JOC) meetings with accounts and present to senior leaders
• Educate accounts on a wide range of topics to enhance their knowledge and compliance with policies, procedures, and best practices, in collaboration with others
• Understand and engage with other departments to support all aspects of provider relations
• Develop and maintain beneficial relationships with key departments to support account management
• Think outside the box to develop creative solutions for account challenges
• Work independently with strong self-guidance and motivation
• Monitor and assist accounts' with OSHA compliance to ensure safety standards are met

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.

Required Qualifications:

• 4 years of experience in a network management-related role, such as contracting or provider services
• 3 years of experience in fee schedule development using actuarial models
• 3 years of experience using financial models and analysis to negotiate rates with providers
• 3 years of experience in performing network adequacy analysis
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
• Intermediate level of knowledge of claims processing systems and guidelines

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.    

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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