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Director of Network Contracting - Eden Prairie, MN, Irvine, CA or Schaumberg, IL more...
Location:Hopkins (Eden Prairie), MN
Company:OptumRx
First posted:June 13, 2017
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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 life's best work.(sm)

The Director of Network Contracting is responsible for the full range of provider contracting and service interactions within UnitedHealth Group, including working on end-to-end provider claim and call quality, ease of use of pharmacy portal, future service enhancements, and training & development of external provider education programs. The Director of Network Contracting designs and implements programs to build and nurture positive relationships between the health plan, providers (pharmacies), and members. Responsibilities also include directing and implementing strategies relating to the development and management of a provider networks, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and supervising research and remediation of claims issues.

Primary Responsibilities:

Develop and manage complicate provider relationships while driving positive NP
Develop functional, market, strategy, plans, production and/or organizational priorities
Own end to end processes including network contracting, strategy, implementation and COGs modeling
Identify and resolve technical, operational and organizational problems outside own team
Product, service or process decisions are most likely to impact entire functions and/or customer accounts (internal and external)
Develop staff
Manage RFP responses for Network Contracting
Role located in Eden Prairie MN, Schaumburg IL, or Irvine CA
Work from home will not be considered

Required Qualifications:

5+ years of sales, provider contracting and/or network management experience
5+ years of management experience
Intermediate level of knowledge of claims/systems processes, contracting and reimbursement methodologies
5+ years of experience with Medicare and Medicaid regulations
Exceptional presentation, written and verbal communication skills
Ability to work independently and remain on task
Good organization and planning skills
Ability to work with contractual language
Ability to prioritize and meet deadlines from multi-staff members within the department
Expert level of proficiency with MS Word, Excel, and PowerPoint
Ability to travel up to 25% as required
Preferred Qualifications:

Undergraduate degree
UnitedHealth Group is working to create the health care system of tomorrow. Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good. Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed. Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

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: Network Contracting, Pharmacy Contracting, Provider, Contract Management, Eden Prairie, MN, Minnesota, Irvine, CA, California, Schaumburg, IL, Illinois

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