Executive Director - IPA - Rancho Cucamonga, CA - Full-time / Part-time

** Responsible for leading one of the largest and most complex Independent Practice Associations (IPA) in the NAMM network located in Rancho Cucamonga, CA.
 
Manage, supervise, and direct activities to facilitate financial performance of the provider network. Including develop / implement budgets and market planning, registration of health plan and provider contracts, computation and distribution of monthly capitation payments, adjudication and payment of fee-for-service claims, processing fee-for-service referrals and hospital pre-certification requests. Provide support to Utilization Management / Quality Assurance process; provide management information to group providers. Direct supervision of network development (contracting and credentialing), health education, provider relations, and support of participating physician and ancillary providers.
 
 
Primary Responsibilities:


Leadership role in implementing ideas and guiding staff members toward accomplishment of designated tasks and assurance of quality improvement

Employee supervision via formal and informal meetings, including performance reviews, assistance with problems on projects. Guide, motivate, coach and train employees

Foster interpersonal relationships, showing empathy and understanding towards staff, protecting individual self-esteem. Understand own impact on others; interact effectively with peers, subordinates, and supervisors

Monitor and control work progress. Control allocation and monitor progress of projects, productivity, finances, and materials

Delegate work to subordinates, including sharing new information, explaining objectives, clarifying responsibility and authority, and establishing deadlines

Plan and organize priorities. Establish work objectives, develop procedure or course of action to achieve goal

Responsibility for provider and plan member satisfaction

Develop and maintain annual financial and operational performance objectives

Develop and maintain a budget process

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 experience managing direct reports

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

5 years of experience within a Managed Care environment

2 years of experience in Provider Contracts

Experience managing a P&L

The ability to travel weekly within the Ontario and Riverside counties to different facilities for work
  
Preferred Qualifications:


Bachelor’s 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, Rancho Cucamonga, CA, California