Director of Network Contracting - Philadelphia, PA - 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, covering the eastern Pennsylvania area.

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:
- Develop and execute strategies for a function or discipline that span a large business unit or multiple markets/sites.
- Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency.
- Direct others to resolve business problems that affect multiple functions or disciplines.
- Product, service or process decisions are most likely to impact multiple functions and/or customer accounts (internal or external).

** This role will be based in Philadelphia, PA **

Keywords: Healthcare, Contracting, Account Manager, Negotiation, Business Development, Manager, Consultant, Director

Requirements:
- 8+ years experience in a network management-related role handling complex network providers with accountability for business results.
- 8+ years experience in the health care industry.
- 5+ years experience in developing of product pricing and utilizing financial modeling in making rate decisions
- 3+ years experience developing and managing a medical cost and administrative budget

- Advanced knowledge of the eastern Pennsylvania market 

- Expert level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
- 5+ years experience with provider contracting.
- 5+ years of management experience

- Undergraduate degree or equivalent experience

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your 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.