Vice President of Network Management - Telecommute Opportunity

The Vice President of Network Management will lead the development of a contracted provider network in Local Care Delivery's (LCD) new markets around the country, including the development of contracting strategies, reimbursement methodologies and documents for physicians, hospitals, and ancillary networks.  This position will also support provider contracting growth strategies in existing Collaborative Care markets.

 

·  Responsible for executing the provider network contracting and recruitment efforts for LCD's new markets. 

·  Develops the contracting process, including contract development, for physicians, facilities and ancillary services.

·  Collaborates with finance, healthcare economics, legal and other LCD operational areas to develop and monitor creative provider compensation and incentive models.

·  Negotiates multi-payer and multi-product based provider contracts and collaborates with Local Care Delivery leaders in the implementation of this strategy.

·  Coordinates with Payer/Product Development and Network Development teams to ensure provider contracting approach reflects current and future payer and product strategies.

·  Ensures that a comprehensive provider network is established and maintained in order to meet regulatory, compliance, health plan and LCD business objectives and market expansion opportunities in each market.

· Coordinates physician strategy with hospital strategy to ensure synergistic approach that will provide opportunities for a high level of medical management and data exchange.

·  Support the hiring and training of new provider contracting team in each new local market, as needed.

·  In existing markets, collaborates with each LCD's network development and contracting teams to develop and execute strategies and contract negotiations. 

·  Establishes and maintains strong working relationships with high level management and leaders of key hospital systems, ancillary vendors, as well as regional UnitedHealthcare leadership. 

·  Executes market-specific network contracting strategies.

·  Oversees and manages ancillary contracting strategies.

·   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 UHC operational areas and assists in intersegment agreements.

·   Direct oversight of Physician Contracting Associates in their daily activities to recruit contracted physicians into the risk-bearing entity within each LCD.

·   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:

· Ten years in a network management role with accountability for business results, including five years in a management/leadership role

· Master's degree in business, health care management or related field, or equivalent experience 

· Excellent knowledge of health care industry

· Advanced knowledge of payment alternatives including fee for service, capitation, global budget, performance compensation, and episode of care payment, as well as patient and practice risk adjustment mechanics, HEDIS and premium based payment methodologies.

· Advanced negotiation skills and experience; the ability to gain acceptance from others of a plan or idea and achieve a mutually beneficial outcome

· Excellent problem solving skills, including the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action.

· Familiarity with patient and practice risk adjustment mechanics, APR; HCC/RAF:

· Familiarity with conventional payment methodologies (CMS-RBRVS)

 

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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.