Optum Logo

Optum

Associate Director, Network Contracting - Remote in NY, NJ, CT

Posted 6 Days Ago
Be an Early Applicant
In-Office or Remote
Hiring Remotely in New York, NY
113K-193K Annually
Senior level
In-Office or Remote
Hiring Remotely in New York, NY
113K-193K Annually
Senior level
Leads provider network development and contracting for competitive, stable, affordable healthcare networks. Negotiates provider agreements, evaluates contract performance, applies reimbursement and incentive models, analyzes financial and market data, and develops network and contracting strategies. Maintains relationships with skilled nursing facilities and business partners while supporting Medicare, managed care, employer, individual, community, and state products. The role requires network management, medical cost, provider contracting, financial modeling, and reimbursement expertise, with remote work during EST hours and travel to New York.
The summary above was generated by AI
Requisition Number: 2381044
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Associate Director, Network Contracting will guide the development and support of provider networks as well as unit cost management activities through financial and network pricing modeling, analysis and reporting.
They will be responsible for developing the provider network, yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and produces an affordable and predictable product for customers and business partners.
The Associate Director, Network Contracting will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. In addition, it's key for this leader to establish and maintain solid business relationships with the Skilled Nursing Facilities and other business partners to ensure the network composition includes an appropriate distribution of provider specialties.
If you have the ability to work EST standard business hours, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
  • Balance financial and operational impact of contracts to providers, members, UHN, and different customer groups when developing and/or negotiating contract terms
  • Develop functional, market level and/or site strategy, plans, production and/or organizational priorities
  • Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
  • Demonstrate understanding of applicable products for different lines of business (Employer and Individual; Medicare and Retirement; Community and State)
  • Evaluate current contract performance to identify potential remediation opportunities and/or cost savings
  • Demonstrate understanding of and utilize applicable financial tools and reports (internal financial models; external reports) to evaluate performance of current contracts
  • Demonstrate understanding of contract language in order to assess financial and operational impact and legal implications of requested contract changes
  • Demonstrate understanding of competitor landscape within the market (rates; market share; products; provider networks; market intelligence; GeoAccess)
  • Represent department in external meetings to gather relevant information, recommend solutions, execute on deliverables as assigned and explain results/decision/activities
  • Develop and/or implement contracting strategies to support new benefits designs and plans

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:
  • 5+ years of experience in a network management-related role handling complex network providers with accountability for business results
  • 2+ years of medical cost and affordability experience
  • 2+ years of experience with provider contracting and/or provider network management
  • Experience using financial models and analysis to negotiate rates with providers
  • Proven solid knowledge of Medicare and Managed Care Reimbursement
  • Driver's License and access to reliable transportation
  • Ability to travel 25% to NY
  • Ability to work EST standard business hours

Preferred Qualifications:
  • Experience with contract negotiations
  • Experience developing product pricing and utilizing financial modeling in making rate
  • Reside in NY, CT, or NJ

*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 $112,700 - $193,200 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 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

An Hour Ago
Remote or Hybrid
92K-164K Annually
Mid level
92K-164K Annually
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Supports actuarial analyses for provider evaluation, network strategy, premium designation, and healthcare affordability. Analyzes claims, enrollment, provider, utilization, and financial data; builds and validates models, datasets, dashboards, and reporting processes; develops methodologies; and communicates recommendations to cross-functional stakeholders. The role also supports peer review, governance, documentation, workflow automation, reproducibility, and scalable analytics.
Top Skills: DatabricksExcelPythonRSASSparkSQL
6 Days Ago
In-Office or Remote
92K-164K Annually
Mid level
92K-164K Annually
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Supports Epic claims and remittance systems within a revenue cycle IT team. Responsibilities include configuring, testing, maintaining, and troubleshooting Epic PB and HB workflows; supporting upgrades, implementations, production incidents, and on-call operations; translating business requirements into specifications; maintaining documentation; facilitating stakeholder sessions; and ensuring compliant system changes and reliable data flow.
Top Skills: EdiEpic EmrEpic Resolute Hb Claims And RemittanceEpic Resolute Pb Claims And RemittanceExcelMicrosoft TeamsMicrosoft WordServicenow
6 Days Ago
In-Office or Remote
Senior level
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Lead planning and delivery of NY APD infrastructure modernization and operations. Coordinate system and database administration teams and vendors, manage project plans, risks, and schedules, and oversee ServiceNow incident/problem management. Drive capacity planning, security and compliance (HIPAA), SLA and performance monitoring, executive reporting, and infrastructure support for MPI, provider index, data platforms, submitter onboarding, and public portal components.
Top Skills: Business IntelligenceCloud TechnologiesData AnalyticsData WarehousingDatabase PlatformsDevOpsEdiHipaaHl7Master Patient IndexMaster Provider IndexMonitoring ToolsServicenow

What you need to know about the Seattle Tech Scene

Home to tech titans like Microsoft and Amazon, Seattle punches far above its weight in innovation. But its surrounding mountains, sprinkled with world-famous hiking trails and climbing routes, make the city a destination for outdoorsy types as well. Established as a logging town before shifting to shipbuilding and logistics, the Emerald City is now known for its contributions to aerospace, software, biotech and cloud computing. And its status as a thriving tech ecosystem is attracting out-of-town companies looking to establish new tech and engineering hubs.

Key Facts About Seattle Tech

  • Number of Tech Workers: 287,000; 13% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Amazon, Microsoft, Meta, Google
  • Key Industries: Artificial intelligence, cloud computing, software, biotechnology, game development
  • Funding Landscape: $3.1 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Madrona, Fuse, Tola, Maveron
  • Research Centers and Universities: University of Washington, Seattle University, Seattle Pacific University, Allen Institute for Brain Science, Bill & Melinda Gates Foundation, Seattle Children’s Research Institute

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account