10 hours
2018-06-182018-07-18

Director of Network Strategy and Provider Relations - Indianapolis, IN

UnitedHealth Group
Indianapolis, IN
  • Job Code
    745515
745515 Director of Network Strategy and Provider Relations Indianapolis IN

Director of Network Strategy and Provider Relations - Indianapolis, IN (745515)

Position Description

The time has come to raise your game and help us raise ours. You've learned to lead. You've built a deep expertise in health care network operations. You've set your sights on having more impact in more ways. Now it's time to join our leadership team and help UnitedHealth Group meet the challenge of shaping where health care will go. As an Associate Director 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 6 leader.

The Director of Network Strategy and Provider Relations will be a member of the Optum Indiana leadership team responsible for developing and growing the Optum Institutional Special Needs Plans (ISNP) network and membership.  The Director of Network Strategy and Provider Relations must be a sophisticated, business-minded executive who is able to build win-win relationships with the skilled nursing community, provide thought leadership and innovation in the progressive and sustained growth of the Optum clinical model.

 

The Director of Network Strategy and Provider Relations is responsible for the contracting and network management activities for skilled nursing facility (SNF) networks for all United lines of business in the Indiana region.  S/he establishes a competitive SNF network that meets all state, federal and business network adequacy requirements; achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners.  The Director of Network Strategy and Provider Relations evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls; responsible for creating and maintaining strong, collaborative relationships with SNF providers.

 

The Director of Network Strategy and Provider Relations is responsible for the development and execution of business strategy for all UnitedHealthcare Special Needs Plans health plans.

 

Primary Responsibilities:

  • Ability to travel throughout Indiana to provide service and expand relationships with skilled nursing home community; Establish and execute on growth strategies with new and existing clients
  • Ability to analyze data to propose contract models and fee schedules; Determine the need for special contract arrangements with providers and execute those negotiations
  • Responsible for the direction and management of all network-related Provider Relations activity, for meeting targets and driving company revenue; Ability to create and convey a strategic vision / translate strategic initiatives into tactical actions
  • Assess and interpret customer needs and requirements; Adhere to unit cost targets and access standards for payer clients
  • Capable of managing a variety of complex issues while driving key projects; Ability to take and manage risks
  • Ability to develop and maintain professional working relationships with skilled nursing home providers in region; Ability to work collaboratively with colleagues and staff to create a results-driven, team-oriented environment
  • Provides leadership to and is accountable for the performance of managers and/or professional staff; Develop, coach, and guide others

Required Qualifications:

  • Bachelors Degree or High School Diploma / GED with 10 or more years of experience with Provider Relations
  • 4 or more years of progressive healthcare management experience with strong preference for managed care or skilled nursing industry experience
  • 2 or more years of experience in a network management-related role handling complex network providers with accountability for business results; Experience managing a medical cost and administrative budget
  • 2 or more years of experience with provider contracting
  • Knowledge of Medicare and Medicaid regulations and requirements including payment guidelines and reimbursement methodologies such as DRGs, RUGS, etc; Comprehension of policies and standards related to Medicare Advantage and Special Need Plans (SNP’s) is essential to the role
  • Familiarity with local and national market trends in skilled nursing community and in managed care industry
Preferred Qualifications:
  • Experience working with or negotiating a complex solution to the physician, healthcare community
  • Understanding of product pricing development and financial modeling; Knowledge of financial reimbursement methodologies, including pay for performance, incentive-based reimbursement models
  • 2 or more years of experience in a leadership role; Demonstrated leadership skills in Provider Relations, and/or new product implementation
Soft Skills:
  • Possess strong contract negotiation skills and contracting knowledge
  • Possess strong strategic and business acumen well-grounded in healthcare delivery systems

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 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)

 


 

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: Director, Network Strategy, Provider Relations, Indianapolis, IN, Indiana

Job Details

  • Contest Number745515
  • Job TitleDirector of Network Strategy and Provider Relations - Indianapolis, IN
  • Job FamilyNetwork Contracting and Pricing
  • Business SegmentOptumCare

Job Location Information

  • Indianapolis, IN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelDirector
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusExempt

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Director of Network Strategy and Provider Relations - Indianapolis, IN

UnitedHealth Group
Indianapolis, IN

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UnitedHealth Group
Indianapolis, In

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