Director of Payor Contracting - Ontario, CA - Full-time / Part-time

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) 

Primary Responsibilities: 


Participate in the negotiation; implementation, and operational issue resolution of all NAMM California health plan contracts 

Act as a liaison with health plans and NAMM Operations Departments 

Responsible for negotiating health plan contracts / amendments  

Oversight of the implementation process of payor contracts / amendments and issues with internal Operations, tracking renewals, financial analysis associated with payor contracts, and creation of contract tools for internal uses 

Oversees the development of the Health Plan Operations program and staff while managing departmental projects 

All other duties as assigned by Vice President of Contracting, Claims and Configuration 

Required Qualifications:

Bachelor’s Degree required in a related field or 3-5 years equivalent, related to health care experience
3 years management experience of the payor contracting process from preparation, negotiation, implementation with an ability to understand key contract structure, DOFR & their financial implications
An individual with a general understanding of the healthcare industry and or local physicians market, managed care alternative delivery systems as well as knowledge of relevant federal and state regulations
General understanding of health care delivery system or management service organization (MSO) operationsKnowledge of operational process within the MSO/IPA model
Computer proficiency in Excel, PowerPoint, Word, Outlook and Access
Ability to develop Power Point presentations and basic formatting with utilization of databases and spreadsheets
Ability to communicate written & orally in an effective & diplomatic manner
Skill in organizing information and prioritizing goals & responsibilities 


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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 managers 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:  network contracting, payor, IPA, MSO, hospital, contracts, MS Office, manager, director, Ontario, CA, California