Associate Director, Network Contracting - Wauwatosa, WI (Office-Based)
About the Job
The time has come to raise your game and help us raise ours. You've learned to lead. You've built a deep expertise in health care network operations. You've set your sights on having more impact in more ways. Now it's time to join our leadership team and help UnitedHealth Group meet the challenge of shaping where health care will go. As an Associate Director within our network contracting team, you'll guide the development and support of provider networks as well as unit cost management activities through financial and network pricing modeling, analysis and reporting. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader.
- ACO Contracts
- Management and coordination of ACO activities through initial negotiation phase, activation phase, and day to day maintenance. Follows up on open items including maintaining trackers – Assigns accountability to each action item at the end of meetings
- Ensure coordination with local market teams: Provide regular updates to local LOB leadership on ACO performance
- Responsible for performance of ACO (including provider satisfaction).
- Clinical action plan owner-work collaboratively with the ACO Core Team to develop, create, implement, track and update the clinical action plan
- Tactical execution of the clinical action plan objectives to drive success
- Subject matter expert on impact on Attribution, Assignment, and how incentives are paid-specific to ACO arrangements
- Schedules and develops agendas for implementation meetings, takes and distributes notes from implementation meetings, etc.
- Work collaboratively with ACO Core Team members to share knowledge of all internal and external ACO meetings (clinical, data, legal, etc.) to ensure continuity and follow up is completed (may or may not attend)
- Health System Fee For Service Negotiations
- Develops the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners
- Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
- Establishes and maintains strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties
Are you ready to put your skills to the test? In this high-impact role, you will need to be a strong leader and have the proven ability to establish trust and build relationships with leaders and experts across an organization.
- Undergraduate or equivalent work experience
- 5+ years of supervisory level experience in a network management-related role handling complex network providers with accountability for business results
- 2+ years of experience utilizing financial modeling in making rate decisions
- 2+ years of experience managing a medical cost and administrative budget
- 2+ years of experience with provider contracting
- Knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
- Must live within the vicinity for this specific career opportunity
- Value Based Contracting/ ACO experience
- Healthcare System Contracts
- Experience communicating and interacting with senior leadership and will have strong project management experience and experience working in a matrixed environment.
Creating and fine-tuning provider networks helps improve access to health care for millions. It's an outstanding opportunity to have more meaning and purpose in your career. Join us. Find out how you can start doing your life's best work.(sm)
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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: 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.