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in Richmond, VA

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Hours Full-time, Part-time
Location Richmond, VA
Richmond, Virginia

About this job

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 Associate Director Network Contracting will contribute to the acceleration of contracting initiatives targeted at establishing and enhancing Accountable Care Organizations (ACO). This position will operate within an assigned region and work closely with the Contracting Director focused on ACOs. This position will support all lines of business but may focus on one more heavily depending on business needs (Ex: Medicaid). This position will partner with current UHN contracting staff in the assigned region. 


 


Primary Responsibilities:




  • Contract with ACOs and manage the relationships on behalf of UnitedHealthcare within the assigned region to achieve organizational goals

  • Ensure the ongoing success of the ACO relationships by resolving technical, operational and organizational problems

  • Enhance ongoing improvement in the care delivery provided to UHC members by developing ACOs focused on service and quality of care

  • Work across department lines to coordinate contracting objectives (Ex: work with Clinical, Affordability, Health Care Analytics and all lines of business)

  • Provide support to the continued alignment between all components of the ACO network development process (Ex: product development & evolution, network advocacy)

  • Effectively utilize network configuration and incentive-based payment models as appropriate to improve quality and efficiency

  • Influence senior management decisions that impact business direction

  • Establish and maintain strong business relationships with hospital, physician, pharmacy or ancillary providers to ensure the ACO composition includes an appropriate distribution of provider specialists

Requirements

Required Qualifications:




  • Undergraduate degree in applicable area of expertise or equivalent experience

  • 7+ years of experience in a network management-related role handling complex network providers with accountability for business results

  • 7+ years of experience in the health care industry

  • 6+ years of experience with provider contracting

  • 6+ years of experience in contributing to the development of product pricing and utilizing financial modeling in making rate decisions

  • 4+ years of experience managing 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.

  • Strong customer service skills

  • Excellent verbal and written communication skills

  • Strong interpersonal skills, establishing rapport and working well with others

  • Ability to prioritize numerous tasks, and to work under time constraints

  • Strong analytical, critical reasoning and organizational skills

  • Knowledge of Accountable Care Organization programs and contracts

Preferred Qualifications:



  • 2+ years of experience in the development of product pricing and utilizing financial modeling in making rate decisions

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 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, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.


 


UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.