UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) 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)If you are located in Las Vegas NV, Colorado, Idaho or Utah, 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 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 hospital contracts in compliance with company templates, reimbursement structure standards and other key process controls Ensure that network composition includes an appropriate distribution of providers Provide explanations and information to others on difficult issues Review work performed by others and provide recommendations for improvement Forecast and plan resource requirements Authorize deviations from standards 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.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: Bachelor's degree or equivalent 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 2+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions 2+ years of experience in performing network adequacy analysis Intermediate level of knowledge of claims processing systems and guidelines In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc. Preferred Qualifications: Undergraduate degree Contracting and negotiations experience "UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status."Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm) Colorado Residents Only: The salary range for Colorado residents is $79,700 to $142,600. 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.Job Keywords: Contract negotiation, Contract management, Physician, Hospital and ancillary contracting, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote
UnitedHealth Group
Las Vegas Nevada
United States
Other
(No Timezone Provided)
UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) 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)If you are located in Las Vegas NV, Colorado, Idaho or Utah, 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 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 hospital contracts in compliance with company templates, reimbursement structure standards and other key process controls Ensure that network composition includes an appropriate distribution of providers Provide explanations and information to others on difficult issues Review work performed by others and provide recommendations for improvement Forecast and plan resource requirements Authorize deviations from standards 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.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: Bachelor's degree or equivalent 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 2+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions 2+ years of experience in performing network adequacy analysis Intermediate level of knowledge of claims processing systems and guidelines In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc. Preferred Qualifications: Undergraduate degree Contracting and negotiations experience "UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status."Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm) Colorado Residents Only: The salary range for Colorado residents is $79,700 to $142,600. 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.Job Keywords: Contract negotiation, Contract management, Physician, Hospital and ancillary contracting, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote