Executive Director, Network Contracting - Ontario, CA

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 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. Associate 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. Primary Responsibilities:Own an end to end processDevelop functional, market level, and/or site strategy, plans, production and/or organizational prioritiesApply network configuration and incentive-based payment models as appropriate to improve quality and efficiencyIdentify and resolve technical, operational and organizational problems outside own teamProduct, service or process decisions are most likely to impact entire functions and/or customer accounts (internal or external)

Required Qualifications:Undergraduate degree or equivalent experience5+ years experience in a network management-related role handling complex network providers with accountability for business results5+ years experience in the health care industry2+ years experience in the development of product pricing and utilizing financial modeling in making rate decisions2+ years experience managing a medical cost and administrative budgetExpert level of knowledge of reimbursement methodologies such as Capitation, Case Rates, Per Diem, etc. 2+ years experience with hospital contracting such as negotiating a per diem contract5+ years of supervisory experienceStrong customer service skillsExcellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others, including but not limited to reimbursement policy standardsStrong interpersonal skills, establishing rapport and working well with othersCareers 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 do your life's best work.(sm)North American Medical Management, California, Inc (NAMM California) partnered with OptumHealth in 2012. NAMM California and OptumHealth share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and managers provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform. The NAMM California provider clients represent a network of almost 600 primary care physicians and over 3,000 specialists and work with the premier hospitals in their respective markets.  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.  Job Keywords:  hospital contracting, provider contracting, reimbursement, hospital, hospital network, capitation, per diem, rates, network management, Ontario, CA, California