Associate Director, Network Contracting - Remote

UnitedHealth Group•Seattle, WA

1d•$112,700 - $193,200•Remote

About The Position

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs — helping patients access and navigate care anytime and anywhere. As a team member of our Senior Community Care (SCC) team, we work to provide care to patients in nursing homes, senior housing and assisted living settings. This life-changing work adds a layer of support to improve access to care. We’re connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together. The Associate Director, Network Contracting will guide the development and support of provider networks as well as unit cost management activities through financial and network pricing modeling, analysis and reporting. They will be responsible for developing the provider network, yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and produces an affordable and predictable product for customers and business partners. The Associate Director, Network Contracting will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. In addition, it’s key for this leader to establish and maintain solid business relationships with the Skilled Nursing Facilities and other business partners to ensure the network composition includes an appropriate distribution of provider specialties.

Requirements

5+ years of experience in a network management-related role handling complex network providers with accountability for business results
2+ years of medical cost and affordability experience
2+ years of experience with provider contracting and/or provider network management
Experience using financial models and analysis to negotiate rates with providers
Proven solid knowledge of Medicare and Managed Care Reimbursement
Driver’s License and access to reliable transportation
Ability to travel 25% to AZ, UT, CO, WA, OR
Ability to work PST or MTN standard business hours

Nice To Haves

Experience with contract negotiations
Experience developing product pricing and utilizing financial modeling in making rate
Reside in OR, AZ, UT, CO, or WA

Responsibilities

Balance financial and operational impact of contracts to providers, members, UHN, and different customer groups when developing and/or negotiating contract terms
Develop functional, market level and/or site strategy, plans, production and/or organizational priorities
Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
Demonstrate understanding of applicable products for different lines of business (Employer and Individual; Medicare and Retirement; Community and State)
Evaluate current contract performance to identify potential remediation opportunities and/or cost savings
Demonstrate understanding of and utilize applicable financial tools and reports (internal financial models; external reports) to evaluate performance of current contracts
Demonstrate understanding of contract language in order to assess financial and operational impact and legal implications of requested contract changes
Demonstrate understanding of competitor landscape within the market (rates; market share; products; provider networks; market intelligence; GeoAccess)
Represent department in external meetings to gather relevant information, recommend solutions, execute on deliverables as assigned and explain results/decision/activities
Develop and/or implement contracting strategies to support new benefits designs and plans