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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Network Management

Country:

United States

Postal Code:

90630

Approximate Salary:

Not Specified

Position Type:

Full Time

Vice-President, Strategic Provider Relationships - Southern California

UHG - Cypress, California

Posted: 10/12/2018

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. We’re driving ever higher levels of sophistication in how provider networks are composed and compensated. Your expertise in provider networks can help us build in the next phase of evolution. In this Vice President level role, you’ll use your knowledge and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you’ll discover the resources, backing and opportunities that you’d expect from a Fortune 6 leader.


Primary Responsibilities

  • Ability to develop strategic relationships with senior executives at partner organizations
  • Leveraging Optum’s diverse listing of assets to drive growth
  • Develop, translate and execute strategies or functional/operational objectives including programs that impact markets of customers and consumers
  • Direct cross-functional and/or cross-segment teams to develop enterprise-wide Clinically Integrated Networks focused on specific clinical areas/service lines such as oncology or cardiology
  • Oversee network analysis and strategy development and implementation
  • Drive strategic program design and implementation to improve quality and affordability through improvements in appropriateness and effectiveness
  • Ensure teams are obtaining, validating and analyzing data impacting network availability and access

Get ready for some significant challenge. In this position, you’ll work closely with value-based contracting, analytics and senior leadership in negotiations as you develop and maintain relationships with hospital and physician groups.


Required Qualifications

  • Undergraduate degree or equivalent work experience
  • 10+ 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.
  • 8+ years of experience in data analysis
  • 5+ years of experience managing staff and at least 3 years of project management or project lead experience
  • Proficiency with all facility/ancillary contract reimbursement methodologies
  • 5+ years of experience with claims systems
  • 3+ years of experience with contract submission, validation and maintenance with strong knowledge of business processes that impact facility/ancillary contact loading and auditing

Building diverse, high quality provider networks is creating greater access to health care and improving the lives of millions. Join us. Learn more about how you can start doing your life’s best work.(sm)

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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: Managed Care, health care, Network Program Specialist, network requirements, network assessment, network selection, network data management, provider data analysis, medical claims, claims processing, claims resolution, medical coding, project management, Supervisor, Manager, Director, Vice-President

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