Healthcare Provider Network Contract Manager - Specialty Pharmacy - Remote

Company: UnitedHealth Group
Location: Richmond
Posted on: March 16, 2023

Job Description:

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm)You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:Evaluate, manage, and negotiate large national home infusion & specialty pharmacy contracts, reimbursement structure standards and other key process controlsForecast contract impacts to UHC lines of business, departments, health plans and Optum affiliate companiesIn coordination with UHC healthcare economics and national ancillary colleagues, manage departmental unit cost budgets, target setting, score carding, performance reporting and associated financial modelsDevelop and manage competitive network programs that achieve objectives for performance and adheres to regulatory requirements, trend management and appropriate distribution of providers while managing UHC lines of business, enterprise and health plan expectationsDevelop, maintain and nurture business relationships with nationally contracted providers and identify other target cost-effective, high-quality providers who help UHC achieve MBOsUnderstand and recommend deviations from standard contract language and ratesCoordinate JOCs, communicate enterprise policy, oversee large scale operations projects with Provider Advocate team, and contribute to superior Net Promoter ScoresIn this role, you will need to be able to thrive in a demanding, intense, fast-paced environment. In addition, you'll be driving some complex negotiations while striving to ensure accuracy and affordability.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 work experience5+ years of experience in a network management-related role handling complex network providers with accountability for business results5+ years of experience in the health care industry5+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisionsFull 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 accommodationPreferred Qualifications:Infusion contracting or specialty pharmacy experiencePBM or Pharmacy experienceTo 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 employmentCareers with UnitedHealthcare. Work with a Fortune 5 organization that's serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.California, Colorado, Connecticut, Nevada, New York City, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York City, or Washington residents is $67,800 to $133,100. 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 employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyAt 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: 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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