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In this Outpatient/Professional Network Contractor role, the emphasis will be on completing all recruitment and contracting activities required for an assigned geographic territory to assure the OBHS Commercial, Medicare and Medicaid networks meet Adequacy and Access standards, client expectations and unit cost and trend management goals and objectives. Working collaboratively across a matrixed organization is required to achieve desired results. The environment is fast paced and demanding, so you will be changing priorities often and reacting to the needs of the marketplace and customers.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Recruit and contract with Outpatient/Professional providers to assure OBHS has Commercial, Medicare and Medicaid networks that meet Adequacy and Access standards, client expectations and achieve objectives for unit cost performance and trend management

• Complete contracting tasks required to negotiate provider rate increases, new service locations and new Tax ID numbers

• Complete rate renewals with providers identified for remediation opportunities and/or cost savings

• Work closely with Provider Relations Team, key internal stakeholders, and Project Managers to assure network goals are met

• Clearly communicate status of large network development and contracting initiatives to internal and external customers

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:

• 1+ years of related experience in providers relations or network contracting

• 1+ years of experience using financial models and analysis to negotiate contracts

• Knowledge of claims processing and professional billing/coding guidelines

• Ability to work CST time zone

Preferred Qualifications:

• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)

• Knowledge of provider Credentialing

• Understanding of Managed Care contract language

• Understanding of Medicaid and Medicare pricing and CMS relativity

• Contracting for Behavioral Health

• Experience with Facility/OP provider recruitment

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. 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.

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.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.