[Hiring] Regional Director Network Contracting @UnitedHealth Group

Role Description

The Regional Director will lead Provider Relations Advocates across the Central Region (IN, MN, MO, ND, SD, & TX) with responsibility for enhancing the provider experience, strengthening key stakeholder and market relationships, and overseeing network initiatives across Illinois, Iowa, and Wisconsin. The role will partner closely with leaders across Community & State, Employer & Individual, and Medicare & Retirement sectors to drive provider satisfaction, support network development, and ensure successful execution of regional priorities.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

• Provides leadership to and is accountable for the performance of Contract Managers and senior level professional staff
• Guide development of geographically competitive, broad access, stable Commercial, Medicare and Medicaid networks that meet Adequacy and Access standards, client expectations and achieve objectives for unit cost performance and trend management
• Evaluate current contract performance to identify potential remediation opportunities and/or cost savings
• Review and develop contract language to assess financial and operational impact and legal implications of new or requested contract changes
• Develop and execute strategies for successful new products, implementations/expansions and recruitment initiatives required to meet network adequacy and access standards
• Work closely with the SWAT Contracting Team, Provider Relations Team and Project Managers to assure network goals are met
• Work most often impacts a large business unit, or multiple markets/sites/customers
• Direct and support others to resolve business problems that affect multiple functions or disciplines
• Direct work that impacts entire functions and/or customer accounts (internal and external)
• Clearly communicate status of large network development and contracting initiatives to internal and external customers
• Develop Payment Appendices as needed to support business rate strategy
• Create a team environment that is compassionate, supportive, inclusive, collaborative, curious and goal/performance driven

Qualifications

• 5+ years of management experience in a network contract management-related role handling complex network provider contracts, recruitment, and negotiations with accountability for business results
• 5+ years of experience developing product pricing and utilizing financial modeling and data analytics in making rate decisions
• 5+ years of experience developing and managing a medical cost and administrative budget
• 5+ years of experience with Group, Agency and Facility contracting, contract strategy, rate methodologies, contract language and terms of agreement
• Knowledge of Sales Force and Excel

Requirements

• Behavioral Health contracting experience
• Medicaid, Medicare Advantage and Commercial Contracting for Behavioral Health
• Facility and OP/Professional Contract Negotiations
• Experience reviewing and providing alternative contract language
• Exceptional understanding of Medicaid pricing, Medicare pricing and CMS relativity
• Clear and Effective Communicator both Verbal & Written

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)