Payor Contract Manager- Local Telecommute Only - Ontario, CA

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM


Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

North American Medical Management, California, Inc. (NAMM California) partnered with OptumHealth in 2012. NAMM California and OptumHealth share a common goal of bringing patients, physicians, hospitals, and payers closer together in the mission to increase the quality, efficiency, and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and manages provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services, and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform.

The NAMM California provider clients represent a network of almost 600 primary care physicians and over 3,000 specialists and work with the premier hospitals in their respective markets.

The Payor Contract Manager position is responsible for negotiating health plan contracts and filing of the contracts with the DMHC. Other functions include the oversight of the implementation process of payor contracts and issues with internal Operations, tracking renewals, financial analysis associated with payor contracts, and creation of contract tools for internal uses. The Position oversees the development of the Health Plan Operations program and staff while managing departmental projects. Lastly, all other duties as assigned.

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.

*This is an office based position, however, telecommuters who reside in San Bernardino, Los Angeles, or Orange Counties (California) may be considered. The physical office is located in Ontario, CA.

Required Qualifications:
  • Bachelor's Degree in a related field OR 2+ years equivalent experience, related to health care contracting experience
  • 3+ years management experience of the Commercial and Medicare Advantage contracting process from preparation, negotiation, implementation with an ability to understand key contract structure, financial models, and their financial implications.
  • Knowledge of health care delivery system or management service organization (MSO) operations.
  • Knowledge of operational process within the MSO/IPA model.
  • Proficiency in Excel, PowerPoint, Word, Outlook, and Access.
  • Individual must be able to develop Power Point presentations and basic formatting with utilization of databases and spreadsheets.
  • Ability to communicate written & orally in an effective & diplomatic manner.
  • Supervisory experience

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: 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.

Job Keywords: Payor Contract Manager, Payor, Network Contract Manager, Provider Contracting, DRGs, LGBTQ, Women, BIPOC, Ontario, Riverside, San Bernardino, CA