Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
The Director of Network Contracting develops the provider network (facility, physicians & ancillary groups) yielding a geographically competitive, broad access, stable network that achieves objectives for strategic performance, quality, trend management, and produces an affordable and predictable product for customers and business partners. The Director of Network Contracting evaluates and negotiates 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 Facility, Physician and Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties to remain compliant with our customers.
This leadership position is key in each market, working both externally and internally in evolving health care to keep up with and exceeding industry standards.
You’ll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.
- Accountability for end to end provider network contracting process
- Maintain a sound network of providers within assigned area
- 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
- Identify and resolve technical, operational, and organizational problems both within and outside own team and address to resolution
- Partner with Program, Operations and Process teams to ensure that decisions impacting contracting functions and/or internal and external customer requirements remain compliant
- Ensure sound relationships with internal and external customers are maintained
- Set a sound example of UnitedHealthcare’s Culture values, including ethics and integrity
- Manage a team of associate directors, managers, and contractors
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.
- Bachelor’s degree or equivalent work experience
- 8+ years of experience working with a managed care organization or health insurer; or as a consultant in a network / contract management role, such as contracting, provider services, etc.
- 4+ years leadership experience
- 3+ years of experience working directly on Government Programs
- 2+ years of project management or project lead experience
- Experience with client - facing responsibilities, including issue resolution, expectation management and ongoing reviews
- Working knowledge of Medicare and Medicaid reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
- Experience in the development of product pricing and utilizing financial modeling
- Dental contracting experience
- Experience using standard analytics to determine priorities to determine network contracting priorities
- Accustomed to building brand networks
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)
Colorado Residents Only: The salary range for Colorado residents is $110,200 to $211,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job keywords: Director, Network Contracting, Provider Contracting, Medicare, Medicaid, Government, OptumServe, Optum, UHG, UnitedHealth Group, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Shelton, CT, Connecticut