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Job Details

Physician Contract Manager - Lexington KY

Company name
UnitedHealthcare Networks

Lexington, KY

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Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

The Physician Contract Manager develops the provider network (physicians, hospitals, pharmacies, 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. Physician Contract Managers evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties.

Primary Responsibilities:

Use pertinent data and facts to identify and solve a range of problems within area of expertise

Investigate non-standard requests and problems, with some assistance from others

Work exclusively within a specific knowledge area

Prioritize and organize own work to meet deadlines

Provide explanations and information to others on topics within area of expertise

Required Qualifications:

Undergraduate degree

1 years of professional office experience

At least an intermediate level of knowledge of MS Office (Word, Excel, PowerPoint)

Preferred Qualifications:

Healthcare experience

Prior experience in a network management-related role, such as contracting or provider services

Knowledge of claims processing systems and guidelines

Medicare knowledge

Knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)

Experience utilizing financial models and analysis in negotiating rates with providers

Experience in fee schedule development using actuarial models

Strong interpersonal skills, establishing rapport and working well with others

Strong customer service skills

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6organization 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 where ever 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)

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.

Keywords: healthcare, network management, provider services, Medicare, RBRVS, Lexington, KY, Kentucky

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Company info

UnitedHealthcare Networks

Company Profile

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