RVP Network Contracting - California and Hawaii

UnitedHealth Group•Concord, CA

1d•$200,400 - $343,500•Onsite

About The Position

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Regional Vice President of Network Contracting reports to the West States Senior Vice President and is responsible for leading the California and Hawaii markets. This market leader will represent UnitedHealthcare for all lines of business covering Commercial, Medicare, Medicaid and Exchange products, supporting all provider reimbursement types from fee-for-service to capitated arrangements. This role drives performance against affordability, network stability, and growth objectives while maintaining strong executive-level relationships with key health systems and provider organizations. The RVP serves as the senior market leader accountable for network strategy execution, cross-functional alignment, and team performance across one of UHC’s most complex and high-impact markets. In addition, this leader will need to help develop, design, and manage unique network configurations within each of these business lines to ensure growth and performance of each network meeting UHC needs. Additionally, market leaders build, attract, and develop a best in class performing network contracting team while working with all other UHC teams. The RVP ensures achievement of key performance metrics, including trend, adequacy, and access, ensuring contracting compliance with regulatory requirements, particularly in the heavily regulated California environment.

Requirements

Bachelor’s degree or equivalent experience
10+ years of experience in a network management-related role managing complex network provider systems
10+ years of contracting experience in Network / Provider Management
8+ years of healthcare experience
8+ years of experience in product pricing, financial modeling, and managing a market budget
5+ years of supervisory experience
Experience negotiating capitated, value-based and fee for service arrangements a must
Proven ability to communicate network strategy and drive results
Ability to successfully function in a matrix organization
Ability to successfully leverage relationships both internal and external
Solid independent decision-making skills to drive sound, quality results in a timely manner
Solid ability to operate and influence across the enterprise to drive critical decisions and execution
Demonstrated broad-scope financial expertise

Responsibilities

Develop, design, and manage the medical network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) to yield a geographically competitive network that achieves objectives for unit cost performance and trend management and produces an affordable, predictable product for customers and business partners. As market leader, you will oversee all lines of business to meet the unique expectation of each business lines’ needs
Hire, develop, and retain a high performing contracting team working across company departments to ensure MBOs are met
Lead the local team while also responsible for ensuring all medical contracts are in compliance with UnitedHealthcare’s contract templates and standards, meeting state and federal regulatory requirements
Establish reimbursement structure standards and other key process controls
Ensure the network composition includes an appropriate distribution of provider specialties for each line of business and includes multiple narrow network products
Lead and develop market strategies and visions across multiple lines of business
Develop, translate, and execute business strategies and objectives for respective markets in the California and Hawaii markets for all lines of business
Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
Lead a large multi-state team, setting expectations for strategy development, performance accountability, talent development and succession planning