VP Network Contracting - Omaha, NE at Omaha

Description:

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your lifes best work.The Director of Network Contracting 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. Directors of Network Contracting evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties. In this role you will be expected to:- 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.- Product, service or process decisions are most likely to impact multiple functions and/or customer accounts (internal or external). Since this position will manage both the network contracting and provider service teams for the Nebraska market, we are requiring prior experience in customer service, service management, claim payment or provider service. A strong familiarity with the claim submission and payment process for both physician practices as well as hospitals will be key.

Qualifications:

Requirements:- Undergraduate degree or equivalent experience.- 8+ years experience in a network management-related role handling complex network providers with accountability for business results.- 8+ years experience in the health care industry.- 5+ years experience in developing of product pricing and utilizing financial modeling in making rate decisions- 3+ years experience developing and managing a medical cost and administrative budget- Expert level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.- 5+ years experience with provider contracting.- 5+ years of management experience- Strong customer service skills- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others, including but not limited to reimbursement policy standards.- Strong interpersonal skills, establishing rapport and working well with others.
UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.Together, were removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.
Country: USA, State: Nebraska, City: Omaha, Company: UnitedHealth Group.