Job: Associate Director Network Contracting - Mid-Atlantic Region

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Jobing Description

What makes your career greater with UnitedHealth Group? Growth opportunities among the variety of product lines and making an impact on the healthcare system ensures it will always be challenging and exciting.

The Associate Director of Network Contracting develops the provider network (physicians, hospitals, pharmacies, ancillary groups and 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. Associate Directors of Network Contracting evaluate and negotiate 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 Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties. In this role you will be expected to:

- Own an end to end process.
- Develop functional, market level, and/or site strategy, plans, production and/or organizational priorities.
- Identify and resolve technical, operational and organizational problems outside own team.
- Product, service or process decisions are most likely to impact entire functions and/or customer accounts (internal or external).

Develops and maintains the United Healthcare's Medicare and Medicaid skilled nursing facility (SNF) network for Maryland, DC and northern Virginia. Produces a stable SNF network that achieves objectives for unit cost performance; meets geographic access needs and requirements; and, offers an affordable and predictable product for plan members and business partners. Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards and other key process controls. Establishes and maintains strong business relationships with SNF providers. Responsible for creating and maintaining collaborative relationships with SNF to grow the Evercare Institutional Needs Plan (ISNP) and secure an affordable, accessible, high quality SNF network. This position oversees an internal business that is responsible for a broad network of providers, including action plans for out-of-network utilization and guidance on hospital and specialist participation.

General Profile:
- Provides leadership to and is accountable for the performance of managers and/or senior level professional staff.
- Impact of work is most often at the operational or local business unit or market level.
- Owns an end to end process.
- Develops functional, market level, and/or site strategy, plans, production and/or organizational priorities.
- Identifies and resolves technical, operational and organizational problems outside own team.
- Product, service or process decisions are most likely to impact entire functions and/or customer accounts (internal or external).

Qualifications
- Undergraduate degree in business or health care administration or equivalent experience
- 8 to 10 years of progressively more responsible health care management experience with strong preference for managed care experience
- Minimum of 4 years experience in a leadership role
- Demonstrates broad-scope financial expertise
- Ability to analyze data to model contracts and fee schedules
- PC literacy and proficiency in spreadsheet software
- Strong strategic and business acumen and well grounded in health care delivery systems
- Ability to take and manages risks
- Creates and conveys a strategic vision / translates strategic initiatives into tactical actions
- Ability to build strong relationships within and outside of UHC
- Identifies leaders and develops staff
- Capable of managing a variety of complex issues while driving key projects
- Ability to use project planning tools and resources
- Demonstrates expert negotiation skills
- Actively communicates information and takes initiative to communicate extensively
- Ability to diplomatically handle difficult situations. Confronts issues directly and speaks candidly.

Skills / Requirements

Requirements:
- Undergraduate degree or equivalent experience.
- 5+ years experience in a network management-related role handling complex network providers with accountability for business results.
- 5+ years experience in the health care industry.
- 2+ years experience in the development of product pricing and utilizing financial modeling in making rate decisions
- 2+ years experience managing a medical cost and administrative budget
- Expert level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
- 2+ years experience with provider contracting.
- 5+ years of supervisory experience
- Strong customer service skills
- Excellent verbal and written communication 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 form others, including but not limited to reimbursement policy standards.
- Strong interpersonal skills, establishing rapport and working well with others.
OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.