Director of Network Strategy and Business Development - Skilled Nursing - Maryland Heights, MO

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 Network Strategy and Business Development will be a member of the Optum Saint Louis leadership team responsible for developing and growing the Optum Institutional Special Needs Plans (ISNP) network and membership. The Director of Network Strategy and Business Development must be a sophisticated, business-minded executive who is able to build win-win relationships with the skilled nursing community, provide thought leadership and innovation in the progressive and sustained growth of the Optum clinical model. The Director of Network Strategy and Business Development is responsible for the contracting and network management activities for skilled nursing facility (SNF) networks for all United lines of business in the Saint Louis region. S/he establishes a competitive SNF network that meets all state, federal and business network adequacy requirements; achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. The Director of Network Strategy and Business Development evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls; responsible for creating and maintaining strong, collaborative relationships with SNF providers. The Director of Network Strategy and Business Development is responsible for the development and execution of business strategy for all UnitedHealthcare Special Needs Plans health plans.
 
Primary Responsibilities:

Ability to travel throughout Saint Louis metro-area to provide service and expand relationships with skilled nursing home community
Establish and execute on growth strategies with new and existing clients
Analyze data to propose contract models and fee schedules
Determine the need for special contract arrangements with providers and execute those negotiations
Direct and manage all network-related business development activity, for meeting targets and driving company revenue
Create and convey a strategic vision / translate strategic initiatives into tactical actions
Assess and interpret customer needs and requirements
Adhere to unit cost targets and access standards for payer clients
Manage a variety of complex issues while driving key projects
Take and manage risks
Develop and maintain professional working relationships with skilled nursing home providers in region
Work collaboratively with colleagues and staff to create a results-driven, team-oriented environment
Provide leadership to and is accountable for the performance of managers and/or professional staff; Develop, coach, and guide others

Required Qualifications:

Undergraduate degree in Business, Healthcare Administration or equivalent experience
4+ years of progressive healthcare management experience with strong preference for managed care or skilled nursing industry experience
Demonstrated leadership skills in business development, and/or new product implementation
2+ years of experience in a network management-related role handling complex network providers with accountability for business results
Experience managing a medical cost and administrative budget
2+ years of experience with provider contracting
Strong contract negotiation skills and contracting knowledge
Possess strong strategic and business acumen well-grounded in healthcare delivery systems
Understanding of product pricing development and financial modeling
Knowledge of Medicare and Medicaid regulations and requirements including payment guidelines and reimbursement methodologies such as DRGs, RUGS, etc
Comprehension of policies and standards related to Medicare Advantage and Special Need Plans (SNPs) is essential to the role
Familiarity with local and national market trends in skilled nursing community and in managed care industry
Excellent verbal and written communication skills, strong presentation 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 from others
Strong relationship development and other interpersonal skills
Collaboration with Market and Corporate Senior leaders to develop and execute strategic initiatives for operational improvement and organizational growth
Work cross-functionally across the organization to align company and executive priorities with business development strategy
Strong customer service skills, and ability to manage multiple priorities and rapid change
PC literacy and proficiency in spreadsheet software
Ability to use project planning tools and resources
Preferred Qualifications:

2+ years of experience in a leadership role
Knowledge of financial reimbursement methodologies, including pay for performance, incentive-based reimbursement models
Experience working with or negotiating a complex solution to the physician, healthcare community
 
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)
 
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: Healthcare, Managed Care, Hospital Contracting, Physician Contracting, Ancillary Contracting, Facility Contracting, Provider Network, Network Development, Provider Services, Skilled Nursing Home, Network Management, Long Term Care, Maryland Heights, MO, Missouri