UnitedHealth Group Network Contract Manager - Hartford, CT (or Telecommute for internal) in Hartford, Connecticut
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The Network Contract Manager develops the provider network (large physician groups and other medical professionals) yielding a geographically and financially 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 Tier 1 provider entities, large Physician Groups, IPAs/PHOs and other medical entities, and ensuring the network composition includes an appropriate distribution of provider specialties.
For this role we seek an individual who is knowledgeable in the area of provider contracting concepts including fee for service agreements, alternative payment arrangements, performance contracting and understanding of ACO arrangements. This position is preferably located in the CityPlace building in Hartford, CT.
Assess and interpret customer needs and requirements
Identify solutions to non-standard requests and problems
Work with minimal guidance; seek guidance on only the most complex tasks
Provide explanations and information to others on difficult issues
Establishment of relationships with large CT physician groups, PHO's, IPA's etc.
Utilize knowledge of Emptoris / CLM, acuity for financial models, and experience with performance-based contracting and ACO arrangements
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.
4+ years of experience in a network management-related role, such as contracting or provider services
In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
Experience with performance-based contracting and ACO's
Solid working knowledge of alternative payment methodologies such as bundled case rate payments
Ability to interpret data in financial models and make recommendations based on that data
Willing and able to travel up to 10% regionally
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
3+ years of experience in fee schedule development using actuarial models
3+ years of experience utilizing financial models and analysis in negotiating rates with providers
3+ years of experience in performing network adequacy analysis
Experience working with large physician groups (PHO's, IPA's, other) in CT
Experience with Emptoris / CLM and contracting tools
Ability to multi-task
Excellent verbal and written communication skills
Strong interpersonal skills, establishing rapport and working well with others
Strong customer service skills
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 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: 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 Contract Manager, Resource Based Relative Value System, RBRVS, ACO, Hartford, CT, Connecticut
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