Director, Network Relations - Multiple Locations

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 Provider Service is responsible for the full range of pharmacy provider relations and service interactions within OptumRx. Directors of Provider Service design and implement programs to build and nurture positive relationships between the PBM and our pharmacy network providers.  Responsibilities also include directing and implementing strategies relating to the development and management of a provider network, identifying gaps in network composition and services to assist the network contracting.  May also be involved in identifying and remediating operational short-falls and researching and remediating claims. Additional responsibilities may include representing the network relationship with external PBM clients and customers and being the subject matter expert for specific product offerings.
Primary Responsibilities:

Develop and execute strategies for a function or discipline that span a large business unit or multiple markets / sites
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)
Consideration will be made for position locations in Irvine, CA, Schaumburg, IL or Eden Prairie, MN

Required Qualifications:

Undergraduate degree
5+ years of provider relations and / or network management experience
4+ years of management experience
Expert level of knowledge of claims / systems processes, contracting and reimbursement methodologies
4+ years of experience with Medicare and Medicaid regulations
Exceptional presentation, written and verbal communication skills
Ability to work independently and remain on task
Good organization and planning skills
Ability to prioritize and meet deadlines from multi-staff members within the department
Expert level of proficiency with MS Word, Excel, and Access
UnitedHealth Group is working to create the health care system of tomorrow
Preferred Qualifications:

Master’s Degree
Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.


Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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: director, network relations, network management, provider relations, claims, Irvine, CA, California, Schaumburg, IL, Illinois, Eden Prairie, MN, Minnesota