Director, Healthcare Provider Network Contracting - Denver, CO
Denver, CO 
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Job Description

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

It's time for us to talk because at UnitedHealth Group, there's never better time 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. They can help you bring your impact to a whole new level. As a 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 7 leader.

The candidate will develop 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. They evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. They also establish and maintain strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensure 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.

Primary Responsibilities:

  • Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management

  • Develop and execute strategies for a function or discipline that span a large business unit or multiple markets / sites

  • Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency

  • Direct others to resolve business problems that affect multiple functions or disciplines

  • Direct work that impacts entire functions and/or customer accounts (internal or external)

  • Provide leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff

  • Work most often impacts a large business unit, or multiple markets / sites

In this influential, high-impact role, the emphasis will be on setting strategy and working across a matrixed organization to achieve desired results. The environment is fast paced and demanding, so you will be changing priorities often and reacting to the needs of the marketplace.

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 or equivalent experience

  • 8+ years of management experience in a network management-related role handling complex network providers with accountability for business results

  • 5+ years of experience developing product pricing and utilizing financial modeling in making rate decisions

  • 5+ years of experience with provider contracting

  • 3+ years of experience developing and managing a medical cost and administrative budget

  • Expert level of knowledge of Medicare Resource Based Relative Value System (RBRVS), Diagnosis Related Groups, Ambulatory Surgery Center Groups, etc.

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

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 7 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)

Colorado Residents Only: The salary range for Colorado residents is $110,200 to $211,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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: Director, Healthcare Provider Network Contracting, Healthcare, Managed Care, Hospital Contracting, Physician Contracting, Ancillary Contracting, Facility Contracting, Provider Network, Network Development, Provider Services, Contract Negotiating, Network Management, Accountable Care Organization (ACO), Denver, CO, Colorado

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
8+ years
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