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Network Contract Director - Telecommute

Company: UnitedHealth Group
Location: Miami
Posted on: September 24, 2022

Job Description:

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)

There's never been a time that was more right for people who want to lead. Health care is changing and evolving at a pace that few could have predicted. Technology, ideas and bold vision are taking companies like UnitedHealth Group to new levels of performance. This is the time and the opportunity that can bring your impact to a whole new level. As a leader 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 5 leader.

Position in this function 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. *Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement.

This is a fully remote position, preference is EST of CST time zone. -




  • Industry thought leader
  • Practice SME
  • Develops solutions that transform the industry


    Primary Responsibilities:


    • Manage unit cost budgets, target setting, performance reporting and associated financial models
    • Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
    • Lead the development of new concepts, technologies and products to meet emerging customer requirements
    • Direct cross-functional and/or industry-wide teams with segment-wide and/or enterprise-wide impact
    • Influence senior management decisions that impact business direction
    • Your leadership skills and drive to get things accomplished will be key to your success in this role. The end goal is to produce an affordable and predictable product for customers and business partners within new markets, so you will need to be able to lead us forward and help us develop provider networks with Accountable Care Organizations yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management



      You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
      Required Qualifications:


      • Undergraduate degree in applicable area of expertise or equivalent experience
      • 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 experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
      • 8+ years of experience with provider contracting
      • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
      • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation


        Preferred Qualification:


        • Post graduate degree



          To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

          Careers with LHI. Our focus is simple. We're innovators in cost-effective health care management. And when you join our team, you'll be a partner in impacting the lives of our customers, and employees. We've joined OptumHealth, part of the UnitedHealth Group family of companies, and our mission is to help the health system work better for everyone. We're located on the banks of the beautiful Mississippi River in La Crosse, Wis., with a satellite office in Chicago and remote employees throughout the United States. We're supported by a national network of more than 25,000 medical and dental providers. Simply put, together we work toward a healthier tomorrow for everyone. Our team members are selected for their dedication and mission-driven focus. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)



          Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

          OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Keywords: UnitedHealth Group, Miami , Network Contract Director - Telecommute, Executive , Miami, Florida

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