Vice President Provider Contracting, East Region

 For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. 

The Vice President Provider Contracting East Region is responsible for developing the Optum Care Network 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. They will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. In addition, this leader will establish and maintain strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensure the network composition includes an appropriate distribution of provider specialties.

 

This individual may have direct and indirect reports in multiple locations, serves as a member of the senior management team and has overall accountability for providing leadership, strategic direction and support to all aspects of provider network operations, to include:  establishes and maintains effective professional relationships with physicians, hospital partners, staff, patients and the public. Formulates and administers policies and procedures, participates in strategic planning and business development activities and assists in the professional development of the contracted operations management team.

 

If you are located on the East coast, you will have the flexibility to work remotely* as you take on some tough challenges

 

Primary Responsibilities:

• Recommends, develops and executes strategic long-range planning as it relates to contracted networks in support of the market and enterprise strategic mission, philosophy and goals
• Evaluates and makes recommendations for business development and expansion opportunities within assigned territories
• Oversees the implementation of all expansion projects within assigned territories
• Utilize applicable financial tools and reports (e.g., internal financial models; external reports) to evaluate performance of current contracts
• Balance financial and operational impact of contracts to providers, members, payors, OCN, and different customer groups when developing and/or negotiating contract terms
• Interacts and consults with Network Pricing team to evaluate different financial arrangements and to identify and recommend applicable payment methodologies (e.g., FFS; Case Rate; Sub-capitation; Value-Based Care; Pay for Performance) in order to maximize value for stakeholders
• Ensures compliance and consistent contracting across the enterprise
• Evaluates market rates and provider performance (e.g., billing patterns; referral patterns; quality and effectiveness) in order to establish provider rates and negotiation strategies
• Communicates proposed contractual terms with provider and negotiate mutually acceptable agreement
• Monitors and/or oversee network performance and industry trends to identify opportunities to refine, develop, and/or implement market strategies
• Represents department in internal meetings (e.g., medical management; M&R; C&S) to gather relevant information, present/recommend solutions, and provide updates on results/decision/activities
• Develops and/or implements contracting strategies to support new benefits designs and plans

 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 10+ years related experience in Provider Contracting with an understanding of managed healthcare or equivalent combination of education and experience
• Solid understanding of clinic financials with the ability to analyze operations and continually implement efficient operational processes
• Proven solid business acumen and proven strategic leadership skills
• Ability to travel up to approximately 25% within assigned market and to corporate office for meetings

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

The salary range for this role is $150,200 to $288,500 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

  

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

  

  

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

  

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.