Healthcare Director of Provider Network Contracting and Business Development - Phoenix, AZ - Full-time / Part-time

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

The Director of Network Contracting develops the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. Directors of Network Contracting evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties.

In this role you will be expected to:

- Develops Lifeprint contracting process, including coordination with Optum Local Care Delivery contract development, for facilities and ancillary services.
- Negotiates multi-payer and multi-product contracts and collaborate with other Lifeprint leaders in the implementation of this strategy.
- Establishes and maintains strong working relationships with key payers, hospital systems, ancillary vendors, as well as local UnitedHealthcare leadership.
- Executes market-specific network contracting strategies
- Oversees and manages ancillary contracting strategies, as needed
- Provides leadership, accountability and management in the development and coaching of in-market network contracting resources/teams.
- Acts as Contracting liaison with other Optum and UHG operational areas
- Ensures compliance with all requirements relative to regulatory, accreditation and operational performance; ensures all contracts are filed with and approved by the appropriate regulatory body(ies)
- Participates as appropriate in physician/provider contracting negotiation

Requirements:
- Undergraduate degree preferred.
- 8+ years of experience in a network management-related role handling complex network providers with accountability for business results.
- 8+ years of experience in the health care industry.
- 5+ years of experience in developing of product pricing and utilizing financial modeling in making rate decisions
- 3+ years of experience developing and managing a medical cost and administrative budget
- Expert level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
- 5+ years of experience with provider contracting.

 

Job Keywords:  Healthcare, Managed Care, Hospital Contracting, Physician Contracting, Ancillary Contracting, Provider Network, Network Development, Provider Services, Contract Negotiating, Network Management, Business Development, Sales

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to doyour life's best work.SM

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.




UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.