UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health. 

UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards.

 

Primary Responsibilities:

Responsible for initiating/leadingnegotiations with geography-specific laboratories in accordance with UnitedHealthcare standards and processes. 

Monitor respective geography-specific unit cost performance and improve competitiveness, breadth and stability of laboratory network. 

Determine network adequacy and fill laboratory network gaps in accordance with unit cost targets. 

Ensure integrity of lab network with UnitedHealthcare policies and compliance with pertinent regulatory guidelines. 

Accountable for relevant components of provider relationship management including leadinglaboratory Joint Operating Committee (JOC) meetings and provider outreach/communication. 

Promote use of electronic provider on-line self-service tools in order to support and achieve operational efficiency. 

Monitor activities related to contract load process, engage appropriate service organizations for claims resolution. 

Maintain highest personal/professional integrity and enforce Principles of Integrity and Compliance. 

Translate national laboratory network strategy into regional strategy and objectives. 

Develop and implement: ul TYPEcircle

Laboratory contracting/remediation plan, along with reporting on progress/metrics. 

Provider outreach plan to drive laboratory utilization to in-network laboratories. 

Partners with highest quality, most affordable in-network laboratory vendors to drive in-network utilization. 

Establish/maintain strong collaborative relationships with UnitedHealth Networks/regional Network Management leadership. 

Job Requirements: 
 

Qualifications:ul TYPEdisc

Seven to ten years in a network development/contract management role, such as contracting, etc. 

Bachelors degree in business/health care management/related field. 

Significant additional experience may be considered in lieu of a Bachelors degree, at the discretion of the hiring manager. 

Demonstrated effective negotiation skills and implementation/influencing skills. 

High degree of proficiency in utilizing and interpreting financial models and network adequacy analyses. 

Expert level of knowledge of reimbursement methodologies and clear understanding of Medicare and UnitedHealthcare claims processing guidelines. 

Experience applying pricing, financial analyses and contract standards to the development of Requests for Proposals and negotiation strategies. 

Problem solving skills/including the ability to systematically analyze complex problems/draw relevant conclusions/successfully devise/implement appropriate solutions. 

Excellent verbal/written communication skills/ability to speak clearly and concisely/conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others. 

Proficient in speaking in both individual and group settings. 

Ability to multi-task, shifting back and forth effectively among multiple activities. 

Possesses good interpersonal skills, establishing rapport/working well with others. 

Demonstrated leadership/project management skills

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V 

 

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