Remote Provider Network Management Jobs (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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come makes an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

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.

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

Primary Responsibilities:

• Negotiate and prepare facility agreements that are geographically competitive
• Achieve objectives for unit cost performance and trend management
• Prepare and negotiate value-based, performance-based, and creative contracts for assigned regional facilities
• Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards, and other key process controls
• Collaborates with Provider Network team to ensure that network composition includes an appropriate distribution of provider specialties
• Participate in regional and state-based contracting and/or provider network calls; Possess a willingness and ability to provide explanations and information to others on difficult and/or complex contracting issues (i.e. subject matter expert)

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)
• Proven in-depth knowledge of fee-for-service (FFS), risk sharing, and value-based or "creative" contracting
• Proven intermediate level of knowledge of claims processing systems and guidelines
• Demonstrable knowledge of managed care contracting concepts, provider network access, and CMS and Medicaid rules

*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 to $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.