Vice President Payor Contracting – Remote

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 of Payor Contracting will report to the East Region President of Optum Care Network.  Leads a team responsible for the general management and oversight of all payor contracting activities across the East Region.  Establishing overall strategy for moving to value-based care, managing payor negotiations, establishing product pricing, and driving membership growth.  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.  Adheres to policies, procedures and regulations to ensure compliance and patient safety. Participation in Compliance and other important training is a condition of employment.  

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

Primary Responsibilities:

• Develop long-term strategy for each current and expansion market’s portfolio of payors, products, and pricing
• Lead a team engaging in payor negotiations on behalf of all Optum providers (employed, contracted, and joint-ventured)
• Develop and maintain market-level assessments of payor performance
• Identify and lead initiatives to improve revenue and earnings through payor contracts
• Support standing up capabilities for FFS to Value conversion in new markets
• Understand, assess, prioritize and validate business demands and requirements through direct interaction with business stakeholders and proactive analysis for opportunities to develop and grow the business
• Lead local and regional payor relationships
• Coordinate with Optum’s national team for negotiations and relationships with national payors
• Coordinates activities with marketing, sales, communications and other national/regional functions
• Participate actively in joint venture business meetings as applicable
• Demonstrate understanding of competitor landscape within the market (e.g., rates; market share; products; provider networks; market intelligence; GeoAccess)
• Balance financial and operational impact of contracts to providers, members, payors, OCN, and different customer groups when developing and/or negotiating contract terms
• Interact and consult with Payor 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
• Demonstrate understanding of and utilize applicable financial tools and reports (e.g., internal financial models; external reports) to develop rates
• Utilize appropriate customer relationship management systems (e.g., Salesforce) to manage payor sales efforts.
• Demonstrate understanding of contractual financial and non-financial terms
• Evaluate market rates and medical cost performance in order to establish contract rates and negotiation strategies
• Explain the organization’s direction and strategy to internal partners and providers in order to justify methodologies, processes, policies, and procedures
• Identify and share best practices (e.g., payment methodologies; negotiation tactics) with national and regional colleagues
• Modify and/or develop new payment methodologies in order to execute market strategies
• Present and discuss industry and market trends with internal and/or external groups (e.g., customer groups; brokers; professional associations; providers) in order to facilitate market strategy development and implementation
• Develop and/or implement contracting strategies to support new benefits designs and plans
• Other duties as assigned

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:

• 6+ years of experience in payor contracting
• Experience recognizing and evaluating market trends and specific growth opportunities; Experience with growth and leading expansion efforts
• Experience managing a portfolio of contracts
• Experience engaging directly with senior level executives (e.g., President, CMO); influencing skills; track record of successful client relationship development and ability to quickly build credibility and gain the confidence of individuals at all levels
• Experience owning projects and driving them to completion; solid sense of accountability
• Experience with change management and business transformation
• Experience managing, developing, and mentoring a team
• Payor negotiating experience; track record of achieving objectives in difficult negotiations
• Demonstrated expertise in healthcare, especially the payor or provider space
• Willing and able to travel up to 25% of the time

Competencies:

• Aligning Performance for Success: Focuses and guides others in accomplishing work objectives
• Gaining Commitment: Uses appropriate interpersonal styles and techniques to gain acceptance of ideas or plans; modifies one’s own behavior to accommodate tasks, situations, and individuals involved
• Selecting Talent: Evaluates and selects internal and external talent to ensure the best match between the individual and the work requirements
• Strategic Decision-Making: Obtains information and identifies key issues and relationships relevant to achieving a long-range goal or vision; commits to a course of action to accomplish a long-range goal or vision after developing alternatives based on logical assumptions, facts, available resources, constraints, and organizational values
• Business Acumen: Uses economic, financial, market, and industry data to understand and improve clinic business results; uses one’s understanding of major business functions, industry trends, and Optum’s position to contribute to effective business strategies and tactics
• Developing Others: Plans and supports the development of individuals’ skills and abilities so that they can fulfill current or future job/role responsibilities more effectively
• Leadership Disposition: Demonstrates the traits, inclinations, and dispositions that characterize successful leaders; exhibits behavior styles that meet the demands of the leader role
• Planning and Organizing: Establishes courses of action for self and others to ensure that work is completed efficiently

*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.

OptumCare 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.