30 days old

Director, Healthcare Provider Network Contracting - Oregon / Washington - 889352

Seattle, WA 98104
  • Job Code
    889352

There's never been a time that was more right for people who want to lead. Health care is changing and evolving at a pace that few could have predicted. Technology, ideas and bold vision are taking companies like UnitedHealth Group to new levels of performance. This is the time and the opportunity that can bring your impact to a whole new level. As a leader within our network contracting team, you'll guide the development and support of provider networks as well as unit cost management activities through financial and network pricing modeling, analysis and reporting. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 7 leader.


The candidate will develop the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management and produces an affordable and predictable product for customers and business partners. Evaluate and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Establish and maintain strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties. *Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.


Primary Responsibilities:

  • Manage unit cost budgets, target setting, performance reporting and associated financial models
  • Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
  • Lead the development of new concepts, technologies and products to meet emerging customer requirements
  • Direct cross-functional and/or industry-wide teams with segment-wide and/or enterprise-wide impact
  • Influence senior management decisions that impact business direction


Your leadership skills and drive to get things accomplished will be key to your success in this role.The end goal is to produce an affordable and predictable product for customers and business partners within new markets, so you will need to be able to lead us forward and help us develop provider networks with Accountable Care Organizations yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management.


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:

  • 10+ years of experience in a network management-related role handling complex network providers with accountability for business results
  • 10+ years of experience in the healthcare industry
  • 8+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
  • 8+ years of experience with provider contracting
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.


Preferred Qualification:

  • Post graduate degree


Creating and fine-tuning provider networks helps improve access to health care for millions. It's an outstanding opportunity to have more meaning and purpose in your career. Join us. Find out how you can start doing your life's best work.(sm)


Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)


Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.


UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.


Job Keywords: Network Contracting Director, Network Management, Network Provider, Healthcare, Medicare, Medicare Resource Based Relative Value System, RBRVS, DRGs, Ambulatory Surgery Center Groupers, Seattle, WA, Washington

Categories

Posted: 2020-11-03 Expires: 2020-12-25

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Director, Healthcare Provider Network Contracting - Oregon / Washington - 889352

UnitedHealth Group
Seattle, WA 98104

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