Healthcare Provider Network Contract Manager - Northern California

UHG Oakland, CA

About the Job

It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. As a manager within our network contracting team, you'll guide the development and support of Provider Networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 7 leader.


Get ready for some significant challenge. This is an intense, fast-paced environment that can be demanding. In addition there are some data challenges and unique problems that need to be solved related to gaps in the process.


If you are located in California, you will have the flexibility to telecommute* as you take on some tough challenges.


Primary Responsibilities:

  • Manage unit cost budgets, target setting, performance reporting and interpreting associated financial models
  • Guide development of 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
  • Provide explanations and information to others on difficult issues
  • Develops the provider network (physician medical groups, hospitals, 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
  • Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
  • Establishes and maintains strong business relationships with Hospital, Medical Groups, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties
  • Generally, work is self-directed and not prescribed
  • Works with less structured, more complex issues
  • Serves as a resource to other


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 equivalent experience.
  • 2+ years of experience in a network management-related role, such as contracting or provider services
  • 2+ years of experience in fee schedule development using actuarial models
  • 2+ years of experience using financial models and analysis to negotiate rates with providers
  • Intermediate level of knowledge of claims processing systems and guidelines
  • 2+ years of experience in performing network adequacy analysis
  • Previous contracting experience


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 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 wherever 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 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.



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