Director, Network Contracting, NYC (Relocation Assistance)

Company: UnitedHealth Group ( Learn More )

General Information
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Job Description

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)The Director of Network Contracting develops 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. 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.

This position is office based in NYC and works with all product lines. Relocation may be available for the correct candidate.

Primary Responsibilities:

  • Develop, translate and execute strategies or functional / operational objectives for a region, line of business, or major portion of a business segment functional area
  • Apply network configuration and incentive - based payment models as appropriate to improve quality and efficiency
  • Direct others to resolve highly complex or unusual business problems that affect major functions or disciplines
  • Provides leadership to and is accountable for performance and results through multiple layers of management and senior level professional staff
  • Drive programs that impact markets of customers and consumers

  • Required Qualifications:

  • 10+ years experience in a network management related role handling complex network providers with accountability for business results
  • 8+ years experience in developing of product pricing and utilizing financial modeling in making rate decisions
  • 5+ years experience with provider contracting
  • 5+ years of management experience
  • Expert level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
  • At least an intermediate level of proficiency with MS Excel
  • 5+ years experience delivering presentations
  • Preferred Qualifications:

  • 15+ years experience in the healthcare industry
  • Experience with multiples lines of business
  • Experience with large providers, including hospitals
  • 5+ years experience developing and managing a medical cost and administrative budget
  • Strong customer service skills
  • Excellent verbal and written communication skills
  • Strong interpersonal skills, establishing rapport and working well with others
  • Undergraduate or higher level degree
  • 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: Director, Provider Network Contracting, Provider Contract Negotiation, New York, NY, New York

    Job Requirements