The job below is no longer available.

You might also like

in Phoenix, AZ

Use left and right arrow keys to navigate
Hours Full-time, Part-time
Location Phoenix, AZ
Phoenix, Arizona

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 Network Contract Director will play a critical role in accelerating contracting efforts targeted at establishing and enhancing Accountable Care Organizations (ACO). This position will operate within an assigned region and lead a coordinated effort between UHN contracting staff in place at the market level and a specialized team of contracting professionals responsible for establishing/maintaining relationships with ACOs.  This position will partner with current UHN contracting staff as well as the national UHN team to achieve assigned goals. 


 


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 directing the implementation support resources

  • 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)

  • Facilitate the resolution of operational issues related to managing the total cost of care contract, financial reconciliation and gaps in quality & care performance

  • Maintain alignment between all components of the ACO network development process. (Ex: product development & evolution, network advocacy)

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

  • Educate and  guide senior management decisions that impact direction for all lines of business (Medicare, Medicaid and Commercial)

  • Foster collaboration between lines of business leaders to ensure maximization of opportunities within ACO relationships across businesses

  • 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

  • Set priorities for contracting resources in pursuit of ACO relationships and ensure open, effective, and efficient communication

  • Present complex recommendations on contracting strategies and methodologies to stakeholders orally and in writing

  • Work with Regional Leadership to create and implement complimentary product strategies that improve our cost position and our member's experience

  • Understand competitor strategies to inform the national UHN team about emerging trends, opportunities and challenges

Requirements

Required Qualifications:



  • Undergraduate degree

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

  • 10+ years of experience in the health care industry

  • 8+ years of experience with provider contracting

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

  • 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

  • Knowledge of Accountable Care Organization programs and contracts

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

  • Strong analytical, critical reasoning and organizational skills

Preferred Qualifications:



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

  • Experience managing budgets

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, national origin, protected veteran status, or disability status.


 


UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.