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Senior Network Contract Manager, Transplant - Telecommute

Company: UnitedHealth Group
Location: San Francisco
Posted on: September 24, 2022

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration, and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing -your life's best work.(sm) You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. This self-directed role with OptumHealth will call on your knowledge, your energy, and your commitment to making health care work more effectively for more people. You will manage contracts, cost trend, relationships, and network growth/strategy for Optum's Centers of Excellence provider networks (transplant, cancer, congenital heart disease and VAD) through provider negotiations with large academic hospitals and health systems. This position is responsible for executing on network strategies to meet client and sales goals; contracting competitive rates; evolving the payment methodology to align with the line of business; and managing provider relationships. Primary Responsibilities:

  • Analyze and evaluate payment appendices to strategize options for various contracting approaches and methodologies
  • Evaluate market rates and provider performance (e.g., billing patterns; referral patterns; quality and effectiveness) in order to establish provider rates and negotiation strategies
  • Explain the organization's direction and strategy to providers in order to justify methodologies, processes, policies, and procedures
  • Input contract projections accurately into appropriate tools and analyze financial impact of provider contracts to achieve company goals
  • Communicate proposed contractual terms with provider and negotiate mutually acceptable agreement
  • Establish and manage relationships with providers to navigate operational, legal, financial, and clinical matters What are the reasons to consider working for UnitedHealth Group? - -Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. -Some of our offerings include:
    • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
    • Medical Plan options along with participation in a Health Spending Account or a Health Saving account
    • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
    • 401(k) Savings Plan, Employee Stock Purchase Plan
    • Education Reimbursement
    • Employee Discounts
    • Employee Assistance Program
    • Employee Referral Bonus Program
    • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
    • More information can be downloaded at: - - 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:
      • Undergraduate degree OR 4+ years of equivalent professional experience
      • 5+ years of experience in a network management-related role handling complex network providers with accountability for business results
      • 5+ years of experience in the health care industry
      • 3+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
      • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
      • Knowledge of Medicare and Medicaid regulations
      • Intermediate level of proficiency with MS Excel
      • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation Preferred Qualifications:
        • Experience with organ transplant, cancer, congenital heart and/or ventricular assist device (VAD) specialties To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut / Nevada residents is $90,500 to $161,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. *All Telecommuters will be required to adhere to UnitedHealth Group's 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.

Keywords: UnitedHealth Group, San Francisco , Senior Network Contract Manager, Transplant - Telecommute, Executive , San Francisco, California

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