Optum Logo

Optum

Healthcare Provider Network Contract Manager - Remote

Posted 3 Hours Ago
Be an Early Applicant
In-Office or Remote
Hiring Remotely in Houston, TX
73K-130K Annually
Mid level
In-Office or Remote
Hiring Remotely in Houston, TX
73K-130K Annually
Mid level
Manage provider network development, contracting, unit cost budgets, reimbursement modeling, and network adequacy analysis. Negotiate provider rates using financial and actuarial models, ensure geographically competitive network composition, monitor performance and reporting, and maintain compliance with reimbursement standards. The role also involves explaining complex issues, coaching team members, and guiding network management activities remotely across the United States.
The summary above was generated by AI
Requisition Number: 2390390
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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
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. Take on this managerial role with UnitedHealth Group and you'll be part of a team that's reshaping how provider networks evolve and how health care works better for millions. 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 6 leader.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. 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 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
  • Coach, provide feedback and guide others

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:
  • 4+ years of experience in a network management-related role, such as contracting or provider services
  • 3+ years of experience in fee schedule development using actuarial models
  • 3+ years of experience using financial models and analysis to negotiate rates with providers
  • 3+ years of experience in performing network adequacy analysis
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Intermediate level of knowledge of claims processing systems and guidelines

*All employees working remotely 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 salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.

Similar Jobs at Optum

3 Hours Ago
In-Office or Remote
92K-164K Annually
Senior level
92K-164K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Manages healthcare fraud, waste, and abuse investigations, supervising investigators and ensuring compliance with applicable regulations and program requirements. Provides investigative guidance, oversees case documentation, analyzes fraud trends, supports settlement negotiations and legal proceedings, and collaborates with state and federal partners. The role also includes team supervision, regulatory meeting participation, and travel of up to 25%.
Top Skills: ExcelMicrosoft Word
2 Days Ago
In-Office or Remote
20-36 Hourly
Junior
20-36 Hourly
Junior
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Analyzes, organizes, and submits medical claims documentation for Texas and federal independent dispute resolution proceedings. Tracks IDR cases, ensures regulatory and payer compliance, follows up on submissions, and adjusts claims based on final negotiation, mediation, or arbitration determinations. Collaborates with claims teams, provider-dispute groups, and external stakeholders while protecting confidential information and maintaining data accuracy.
Top Skills: CentricityEpicExcelHipaaMicrosoft Office SuiteOutlookSmartsheetWord
2 Days Ago
In-Office or Remote
73K-130K Annually
Mid level
73K-130K Annually
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Design, develop, test, deploy, and support enterprise full-stack web applications. Build React interfaces, Node.js and .NET/C# microservices, REST APIs, and Azure cloud solutions. Troubleshoot application issues, implement secure coding practices, contribute to architecture modernization, and support CI/CD, DevOps automation, and infrastructure management using Docker, Kubernetes, Jenkins, GitHub Actions, and Terraform. Participate in Agile ceremonies, code reviews, solution design, and continuous improvement initiatives.
Top Skills: .Net.Net CoreAgileC#Ci/CdDockerGithub ActionsGithub CopilotJenkinsKubernetesMicroservicesAzureNode.jsReactRest ApisScrumSQLTerraform

What you need to know about the Chicago Tech Scene

With vibrant neighborhoods, great food and more affordable housing than either coast, Chicago might be the most liveable major tech hub. It is the birthplace of modern commodities and futures trading, a national hub for logistics and commerce, and home to the American Medical Association and the American Bar Association. This diverse blend of industry influences has helped Chicago emerge as a major player in verticals like fintech, biotechnology, legal tech, e-commerce and logistics technology. It’s also a major hiring center for tech companies on both coasts.

Key Facts About Chicago Tech

  • Number of Tech Workers: 245,800; 5.2% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: McDonald’s, John Deere, Boeing, Morningstar
  • Key Industries: Artificial intelligence, biotechnology, fintech, software, logistics technology
  • Funding Landscape: $2.5 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Pritzker Group Venture Capital, Arch Venture Partners, MATH Venture Partners, Jump Capital, Hyde Park Venture Partners
  • Research Centers and Universities: Northwestern University, University of Chicago, University of Illinois Urbana-Champaign, Illinois Institute of Technology, Argonne National Laboratory, Fermi National Accelerator Laboratory

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account