Vice President Payor Contracting - Remote in Washington or Oregon

UnitedHealth Group•Kirkland, WA

22h•$159,300 - $273,200•Remote

About The Position

This role is responsible for developing the strategy for product, payor, and revenue growth plans for the Washington market. The position will drive the negotiation process with accountability for achieving reimbursement terms that meet Optum objectives. They will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. In addition, this leader will establish and maintain solid business relationships with Health Plans, Payors, and major market insurance brokers and purchasers. This individual may have direct and indirect reports in multiple locations, serves as a member of the senior management team and has overall accountability for providing leadership, strategic direction and support to all aspects of payor operations and revenue cycle team, to include establishing and maintaining effective professional relationships with internal and external stakeholders. They will formulate and administer policies and procedures, participate in strategic planning and business development activities and assist in the professional development of the contracted operations management team.

Requirements

10+ years related experience in managed care contracting with an understanding of managed healthcare or equivalent combination of education and experience
Solid understanding of clinic financials with the ability to analyze operations and continually implement efficient operational processes
Proven solid business acumen and proven strategic leadership skills
Proven ability to analyze complex payer contracts and outline a path to performance
Proven ability to lead joint operating committees with the payors
Proven ability to work in a highly matrixed organization
Demonstrated ability to build and leverage high-impact strategic partnerships through deep, relationship-driven engagement.
Proven ability to travel up to approximately 25%25 within assigned market
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Responsibilities

Recommends, develops and executes strategic long-range planning as it relates to contracted payors and product participation in support of the market and enterprise strategic mission, philosophy and goals
Evaluates and makes recommendations for business development and expansion opportunities within assigned territories
Oversees the implementation of all expansion projects within assigned territories
Utilize applicable financial tools and reports (e.g., internal financial models; external reports) to evaluate performance of current contracts
Balance financial and operational impact of contracts to providers, members, payors, Optum Care Network, and different customer groups when developing and/or negotiating contract terms
Interacts and consults with Network Pricing team to evaluate different financial arrangements and to identify and recommend applicable payment methodologies (e.g., FFS; capitation; Value-Based Care; Pay for Performance) in order to maximize value for stakeholders
Ensures compliance and consistent contracting across the enterprise
Evaluates market rates and payor performance in order to establish rate requests and negotiation strategies
Communicates proposed contractual terms with payors and negotiate mutually acceptable agreement
Monitors and/or oversee payor performance and industry trends to identify opportunities to refine, develop, and/or implement market strategies
Represents department in internal meetings (e.g., medical management; M&R; C&S, growth and acquisitions) to gather relevant information, present/recommend solutions, and provide updates on results/decision/activities
Develops and/or implements contracting strategies to support new benefits designs and plans