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.
Here you are in the earlier stages of what could be a deeply rewarding career. You have the potential, the energy and the aspiration to take on meaningful challenges and make a difference. Now, let's talk about what you can do with our leading, global health care organization. UnitedHealth Group is playing a lead role in the formation of new, effective provider networks. As member of our network contracting team, you'll help develop and support Provider Networks and guide unit cost management activities through financial and network pricing modeling, analysis and reporting. As you do, you'll find the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
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Supports the development of the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically 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
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Manage unit cost budgets, target setting, performance reporting and associated financial models
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Predict emerging customer needs and develop innovative solutions to meet them
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Help develop geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
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Evaluate and support contract negotiations in compliance with company templates, reimbursement structure standards and other key process controls
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Ensure that network composition includes an appropriate distribution of provider specialties
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Uses existing procedures and facts to solve routine problems or conduct routine analyses
Get ready for a high impact role. You'll be tasked with working in conjunction with our national clinics and hospitals to manage, collect and analyze provider data, updating and loading provider data and resolving any escalated issues with the clients.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
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High School diploma/GED
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1+ years of experience in a network management-related role, such as contracting or provider services
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1+ years of experience in fee schedule development using actuarial models
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1+ years of experience using financial models and analysis to negotiate rates with providers
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1+ years of experience in performing network adequacy analysis
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At least an intermediate level of knowledge of claims processing systems and guidelines
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Advanced Proficient skillset in Microsoft Excel; ability to create pivot tables, work with large data, create formulas, de-dupe, etc.
Preferred Qualifications:
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Undergraduate degree
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In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
- All Telecommuters 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 hourly pay for this role will range from $24.00 to $43.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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.
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