AVP, Provider Management - Ontario, CA - Full-time / Part-time

The AVP of Provider Management works closely with the SVP to manage the financial performance of all NAMM Independent Practice Association (IPA) operations. Responsibilities include network growth and retention, provider contracting and provider services, developing strong relationships with physician partners, and implementing operational processes to support the company’s strategic direction. This position is part of the OptumCare - NAMM CA Senior management team.
  
Primary Responsibilities:


Strategically plan for the provider network and work closely with senior management to accomplish the goals and objectives of the company

Delegate, monitor and control work progress on achieving key metrics, key initiatives projects, staff productivity, healthcare costs and administrative expenses

Establish operational initiatives for improvement on key metrics, including membership growth, financial performance, compensation model structure and provider relations

Execute on important initiatives within the provider network

Plan and organize priorities, communicate information to staff and monitor progress

Represent the company at various community activities and events. Network regularly with business leaders in the communities in which the company conducts business

Direct IPA budgeting process to include IPA administrative budgets

Oversee and participate in hospital and large ancillary vendor contract negotiations

Work with financial analytics and medical management team to identify opportunities to improve quality, care coordination and cost efficiency, which would include implementation of new payer products, reimbursement models, and advanced care and quality improvement programs

Required Qualifications:


7+ years of Healthcare experience including leadership within a Provider Network or Healthcare Operations area

5 years of experience within a Managed Care environment

5 years of managing direct reports, including managing leaders

2 years of experience in Provider Contracts

Experience managing a P&L

The ability to travel weekly within the counties of San Bernardino and Riverside counties 
Preferred Qualifications:


Undergraduate degree or equivalent experience

Master’s Degree
 
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 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 manages 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: 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: IPA, provider services, management, director, provider network, network operations, contracts, provider contracts, Ontario, Riverside, San Diego