Associate Director of Network Programs - Remote PST
About The Position
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Requirements
- 4+ years of provider relations experience
- 3+ years of experience with Medicare and Medicaid regulations
- Comfortable with Executive Level Presentations
- Demonstrated experience in customer relationship management
- Ability to call on Providers
- Intermediate level of knowledge of claims processing
- Demonstrated proficiency in MS Word, PowerPoint, Excel, and Access
- Demonstrated exceptional presentation, written and verbal communication skills
- Dedicated, distraction-free workspace and access to high speed internet in home
- Ability to travel up to 50%
- Driver’s license and access to reliable transportation
Nice To Haves
- 5+ years of supervisory level experience in a network management-related role handling complex network providers with accountability for business results
Responsibilities
- Lead the development, implementation, and oversight of strategic network initiatives and programs that support customer business objectives
- Analyze provider network performance through analysis of access, adequacy, utilization, quality, financial performance, and operational metrics and identify opportunities for process improvement, efficiency, and provider experience enhancement
- Collaborate with provider contracting, provider relations, operations, regulatory, clinical, and market leadership teams to execute customer specific network strategies
- Lead implementation on client-specific network mandates, ensuring operational readiness and compliance. Includes working directly with clients
- Direct cross-functional projects, including benefit expansions, value-based care initiatives, reimbursement programs, and network transformation efforts
- Analyze market trends, network performance data, and provider feedback to inform leadership decisions specific to customer performance
- Support executive leadership through reporting, program governance, issue resolution, and communication of key network initiatives
- Provide leadership, coaching, and mentorship to network program staff and project teams when applicable
- West Region Direct Payer Network Point of Contact
- Project Manage Provider Bulletins that impact provider networks
- Ensure client specific Network Reporting set up and maintenance
- Support benefit expansion initiatives
- Support network quality improvement initiatives
- Monitor performance guarantees
- Monitor emerging trends coming from provider-facing teams. Implement corrective action plans
- Regulatory and Customer audit – provider network deliverables
- Client QBR participant
- Oversee trade org relationships
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
