Network Contractor - US Telecommute (Philadelphia and Pittsburgh offices preferred) (Nazareth)

Employment Type

: Full-Time

Industry

: Telecommuting/Work-At-Home



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. Heres where you come in. As member of our network contracting team, youll help develop and support Provider Networks and guide unit cost management activities through financial and network pricing modeling, analysis and reporting. As you do, youll discover the impact you want and the resources, backing and opportunities that youd expect from a Fortune 6 leader.


Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.


Primary Responsibilities:

  • 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
  • Respond to the needs of the network as it relates to the contract

Get ready for a high impact role. Youll be tasked with working in conjunction with our physician providers to manage, maintain, and expand the professional commercial, Medicare and Medicaid networks in Pennsylvania and Delaware.

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.


Required Qualifications:

  • Undergraduate degree or equivalent work experience
  • 1+ years of experience in a network management-related role, such as contracting or provider services
  • Basic knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Advanced experience using MS office suite

Preferred Qualifications:

  • 2+ years of experience using financial models and analysis to negotiate rates with providers
  • 2+ years of experience in performing network adequacy analysis
  • Basic level of knowledge of claims processing systems and guidelines

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. Join us. Find out how you can start doing your life's best work.(sm)

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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)

*All Telecommuters will be required to adhere to UnitedHealth Groups 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: Healthcare, health care, Contracting, Account Manager, Negotiation, Business Development, Telecommute, Pennsylvania


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