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Optum

Senior Network Contract Manager - Remote - WA, OR preference

Posted An Hour Ago
Be an Early Applicant
In-Office or Remote
Hiring Remotely in Lake Oswego, OR
92K-164K Annually
Senior level
In-Office or Remote
Hiring Remotely in Lake Oswego, OR
92K-164K Annually
Senior level
Leads complex provider contract negotiations, reimbursement strategy, network development, and agreement implementation. Evaluates financial, operational, market, and contractual data to improve affordability, access, network adequacy, and regulatory compliance. Manages provider relationships and escalations, partners with Legal, Finance, Pricing, and Operations, leads cross-functional initiatives, mentors colleagues, and serves as a subject-matter expert on healthcare contracting and network strategy.
The summary above was generated by AI
Requisition Number: 2393337
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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
The Senior Network Contract Manager is a senior individual contributor and subject-matter expert responsible for developing and executing contracting strategies that support affordability, network adequacy, member access, and regulatory compliance.
This position leads complex negotiations with hospitals, physician groups, Rural Health Clinics, Federally Qualified Health Centers, and ancillary providers. The role is accountable for evaluating contract and market performance, developing reimbursement strategies, managing provider relationships, and advancing agreements from initial strategy through execution and implementation.
The Senior Network Contract Manager also provides leadership through project ownership, cross-functional collaboration, mentoring, review of complex work, and guidance on critical contracting and market issues.
If you reside in Oregon and Washington, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
  • Provider Contracting and Negotiations
    • Lead complex provider contracting and negotiations involving hospitals, physician groups, RHCs, FQHCs, and ancillary providers
    • Negotiate new agreements, renewals, amendments, payment appendices, fee schedules, reimbursement terms, and provider terminations
    • Develop negotiation strategies based on market conditions, financial performance, provider performance, network needs, and business objectives
    • Communicate proposed contractual terms clearly and negotiate mutually acceptable agreements with providers
    • Evaluate continued provider participation based on financial, operational, access, and network considerations
    • Interpret contractual financial and nonfinancial terms, including their operational and legal implications
    • Apply contracting policies, approval requirements, and established standards consistently
    • Ensure agreements are accurately authored, executed, submitted, and configured within required timeframes
  • Market Strategy and Network Development
    • Develop and execute market contracting strategies focused on affordability, network adequacy, member access, competitive positioning, and regulatory compliance
    • Assess market rates, billing patterns, referral patterns, provider quality, and operational effectiveness to establish reimbursement and negotiation strategies
    • Identify opportunities to strengthen network performance, provider alignment, and market competitiveness
    • Support network development, site-of-service strategies, product initiatives, and value-based care expansion
    • Translate market trends, provider intelligence, and financial data into actionable contracting strategies
    • Prioritize and execute contracting initiatives based on business impact, market need, and available resources
    • Apply strategic planning and complex problem-solving skills to resolve critical network and contracting issues
  • Financial and Reimbursement Analysis
    • Evaluate the financial and operational effects of contractual terms on providers, members, UHN, and customer groups
    • Develop provider rates using applicable financial tools, reports, market data, and reimbursement benchmarks
    • Assess contract performance and identify affordability opportunities, financial risks, and potential corrective actions
    • Partner with Network Pricing to evaluate reimbursement arrangements, including fee-for-service, case rates, sub-capitation, pay-for-performance, and value-based reimbursement methodologies
    • Evaluate proposed contract changes for alignment with affordability goals and broader business objectives
    • Use fact-based analysis and sound business judgment to develop contracting recommendations
  • Provider Relationship Management
    • Build and maintain productive relationships with hospital executives, medical group leaders, physicians, and ancillary provider leadership
    • Lead provider discussions involving contract strategy, reimbursement methodologies, performance expectations, and operational requirements
    • Explain organizational direction, contracting methodologies, policies, and procedures to providers and internal business partners
    • Communicate the value and business rationale of applicable reimbursement methodologies
    • Gather and evaluate information regarding provider issues, disputes, and operational concerns
    • Develop resolution strategies, maintain leadership visibility, and escalate significant risks or barriers when appropriate
    • Manage challenging negotiations and provider escalations while preserving productive business relationships
    • Represent the organization professionally in executive-level provider meetings and negotiations
  • Cross-Functional Leadership
    • Partner with Legal, Network Pricing, Finance, Operations, and other internal stakeholders to develop and implement provider agreements
    • Align contracting strategies and recommendations with financial, operational, legal, regulatory, and market requirements
    • Coordinate contract implementation activities to support accurate and timely execution
    • Lead cross-functional projects and provide guidance on complex contracting and network matters
    • Serve as a subject-matter expert and resource to peers, business partners, and leadership
    • Review complex work and provide recommendations that strengthen quality, accuracy, and business results
    • Mentor colleagues and share contracting, negotiation, and market-strategy best practices

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:
  • 3+ years of professional experience in provider contracting, network development, healthcare negotiations, reimbursement, or a related healthcare business function
  • 3+ years of experience negotiating provider agreements or other complex commercial arrangements
  • 3+ years of experience developing and executing negotiation or market strategies
  • Proficiency in contract interpretation, reimbursement methodologies, and contract-performance evaluation
  • Demonstrated ability to evaluate financial, operational, and contractual information
  • Demonstrated ability to manage complex priorities and operate effectively with a high degree of independence
  • Demonstrated solid written, verbal, presentation, and executive communication skills

Preferred Qualifications:
  • Experience negotiating with hospitals, health systems, physician groups, RHCs, FQHCs, or ancillary providers
  • Experience supporting network affordability, adequacy, access, and competitive-positioning initiatives
  • Experience working with contract-management and submission systems
  • Experience partnering with Legal, Network Pricing, Finance, and operational implementation teams
  • Knowledge of healthcare reimbursement methodologies, including fee-for-service, case rates, capitation, sub-capitation, pay-for-performance, and value-based arrangements
  • Solid understanding of healthcare market dynamics, provider performance, and reimbursement strategy
  • Demonstrated success managing provider executive relationships and complex escalations

Core Competencies
  • Complex provider negotiation
  • Financial and reimbursement analysis
  • Market contracting strategy
  • Network development and optimization
  • Strategic planning
  • Complex problem-solving
  • Sound business judgment
  • Executive relationship management
  • Conflict and escalation management
  • Cross-functional influence
  • Contract interpretation
  • Regulatory and policy compliance
  • Project leadership
  • Prioritization and execution
  • Clear and persuasive communication
  • Leadership without direct authority

Success in the Role
Success requires the ability to balance affordability, provider sustainability, member access, network adequacy, regulatory requirements, and organizational objectives. The Senior Network Contract Manager must translate complex financial, market, and operational information into actionable strategies and successfully move provider agreements from analysis and negotiation through execution and implementation.
*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 $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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