Associate Director of Network Programs - Remote PST

UnitedHealth Group•San Diego, CA

1d•Remote

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. So where are we today? The public and health care community are focused on the scope, diversity and quality of provider networks associated with health care products and coverage. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are composed and compensated. That means everything is open to new ideas and innovation. And your expertise in provider networks can help us build in the next phase of evolution. In this managerial role, you'll use your knowledge and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader. You’ll enjoy the flexibility to work remotely on the West Coast as you take on some tough challenges.

Requirements

5+ years of provider relations experience
5+ years of supervisory level experience in a network management-related role handling complex network providers with accountability for business results
3+ years of experience with Medicare and Medicaid regulations
Ability to call on Providers
Intermediate level of knowledge of claims processing
Demonstrated exceptional presentation, written and verbal communication skills
Demonstrated proficiency in MS Word, PowerPoint, Excel, and Access
Ability to travel up to 50%
Driver’s license and access to reliable transportation
Dedicated, distraction-free workspace and access to high speed internet in home
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Responsibilities

Provides leadership to and is accountable for the performance of managers and/or senior level professional staff
Impact of work is most often at the operational or local business unit or market level
Owns an end-to-end process
Develops functional, market level, and/or site strategy, plans, production and/or organizational priorities
Identifies and resolves technical, operational and organizational problems outside own team
Develops innovative approaches
Serves as key resource on complex/critical issues
Lead functional or segment teams or projects
West Region Direct Payer Network Point of Contact
Project Manage Provider Bulletins that impact provider networks
Liaison between Pricing Integrity, Contracting, Onboarding and Provider Relations ensuring “pay as the state pays” alignment with MassHealth regulations
Liaison between provider network and Account Management team
Ensure Network Reporting set up and maintenance
Support benefit expansion initiatives
Support network quality improvement initiatives
Provider network readiness review
Monitor performance guarantees
Monitor emerging trends coming from provider-facing teams. Implement corrective action plans
Establish and maintain Network policies and procedures to comply with regulatory and contractual requirements impacting provider network
Regulatory and Customer audit – provider network deliverables
QBR participant
Oversee trade org relationships