If you are located in Minnesota, you will have the flexibility to telecommute* as you take on some tough challenges. 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 5 leader.
The Director of Network Management & Contracting is a business-minded executive who is able to cultivate, build and maintain win-win relationships with post-acute healthcare providers, provide thought leadership and innovation in the post-acute space, and support sustained growth of Optum and UnitedHealthcare products.
The Director of Network Management & Contracting leads contracting and network management for skilled nursing facility (SNF) networks for all UnitedHealthcare lines of business within a market. This leader builds and refines the SNF network, ensures the network meets all state, federal and business network adequacy requirements, achieves objectives for quality and performance, recommends and drives execution for affordability initatives, and ensures affordable and predictable service for customers and business partners. The Director of Network Management & Contracting drives collaboration and execution against network strategies, facilitates product expansion and implementation, ensures regulatory compliance, adheres to reimbursement structure standards, and supports other key process controls.
- Lead SNF network strategy for the market
- Lead contract negotiations (rates and language)
- Determine the need for special contract arrangements with providers and be accountable for executing those negotiations
- Complete market SNF Network management tasks (contracting, provider relations, gap fills, terminations, etc.)
- Ensure SNF networks exceed requirements for CMS and State network adequacy compliance, in cooridination with M&R and C&S national leads
- Represent or provide for representation for local SNF Network management on all Medicare, Medicaid and Commercial affordability meetings. Coordinate with SMEs to align strategy, priorities, and communication
- Provide leadership to, and be accountable for the performance of managers and staff
- Hire new Network staff, and train both the new and existing network staff according to SNF Network Playbook and published policies, procedures, and best practices
- Collaborate with Optum teams, across Sales, Clinical and related functions, to accomplish enterprise goals
- Support growth strategies with new and existing Optum partners
- Create and convey a strategic vision, and translate strategic initiatives into tactical actions
- Travel throughout the market, interact positively with teams and expand relationships with post-acute providers
- Analyze data to propose contract models and fee schedules
- Assess and interpret customer needs and requirements
- Manage a variety of complex issues while driving key projects
- Take and manage risks
- Develop and maintain professional working relationships with skilled nursing home providers in region
- Work collaboratively with colleagues and staff to create a results-driven, team-oriented environment
- Undergraduate degree in Business, Healthcare Administration or equivalent experience
- 4+ years of progressive healthcare management experience with strong preference for managed care or skilled nursing industry experience
- 2+ years of experience leading Network contracting, management, and/or strategy
- 2+ years of experience in network management, handling complex network providers with accountability for business results
- 2+ years of experience with provider contracting
- Possess strong contract negotiation skills and contracting knowledge
- Possess strong strategic, relationship-management, and business acumen, well-grounded in healthcare delivery systems
- 2+ years of experience working with product pricing development and financial modeling
- 2 + years of experience with 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)
- Experience managing a medical cost, affordability, and administrative budget
- Experience working with or negotiating a complex solution to the physician, healthcare community
- Demonstrated leadership skills in business development, and/or new product implementation
- Solid knowledge of financial reimbursement methodologies, including pay for performance, incentive-based reimbursement mode
- Familiarity with local and national market trends in post-acute care, the skilled nursing community and in managed care industry
- Excellent verbal and written communication skills, strong presentation skills; Ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
- Strong relationship development and other interpersonal skills; Collaboration with Market and Corporate Senior leaders to develop and execute strategic initiatives for operational improvement and organizational growth; Work cross-functionally across the organization to align company and executive priorities with business development strategy
- Strong customer service skills, and ability to manage multiple priorities and rapid change
- PC literacy and proficiency in spreadsheet software
- Ability to use project planning tools and resources
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)
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
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: Healthcare Management, Network Contracting, Network Management, Provider Contracting, Telecommute, Telecommuter, Minnesota