Network Contract Associate Director - Hybrid - Irvine, CA

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care.

Join us to start Caring. Connecting. Growing together.

This is a hybrid role in Irvine, CA - 1 day / week in the office.

Develops the provider network (physicians, 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 complex contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls.

Acts as liaison between the regional leadership and the central contracting department. Works collaboratively with the Senior Vice President and Regional Medical Director on strategic business initiatives including network development and affordability.

Establishes and maintains solid business relationships with 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.
• Company thought leader
• Functional SME
• Broad business approach.
• Resource to senior leadership
• Develops pioneering approaches to emerging industry trends

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
• Supervise and provide direction and guidance to the local negotiator team
• Develop strategies to address affordability and network development initiatives
• Manage complex negotiations including crafting language for distinctive rate structures and incentive plans

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 :

• 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 of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
• 8+ years of experience with provider contracting including direct provider negotiations, capitated agreements and incentive plan modeling
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.

California Residents Only : The salary range for this role is $, to $, annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.

UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and k contribution (all benefits are subject to eligibility requirements).

No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.

We believe everyone of every race, gender, sexuality, age, location and income deserves the opportunity to live their healthiest life.

Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.

We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.

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.