Regional Director Network Contracting, Central Region - Remote

Posted Yesterday
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Hiring Remotely in Overland Park, KS, USA
In-Office or Remote
113K-193K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Leads regional provider contracting and relations across Commercial, Medicare, and Medicaid networks. Manages contract staff, develops network strategies, evaluates contract performance and cost savings, negotiates terms and rates, supports network adequacy, oversees implementations and recruitment initiatives, and communicates progress to internal and external stakeholders. Requires expertise in provider contracting, pricing, financial modeling, medical cost budgets, contract language, and managed-care network development.
Summary Generated by Built In
Requisition Number: 2393488
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
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.
Primary Responsibilities:
  • 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

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:
  • 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

Preferred Qualifications:
  • 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

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 - $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • 5+ years of management experience in network contract management-related roles involving complex provider contracts, recruitment, negotiations, and accountability for business results
  • 5+ years of experience developing product pricing and using financial modeling and data analytics for rate decisions
  • 5+ years of experience developing and managing medical cost and administrative budgets
  • 5+ years of experience with Group, Agency, and Facility contracting, contract strategy, rate methodologies, contract language, and terms of agreement
  • Knowledge of Salesforce and Excel
  • Behavioral Health contracting experience
  • Medicaid, Medicare Advantage, and Commercial contracting for Behavioral Health
  • Facility and outpatient/professional contract negotiations
  • Experience reviewing and providing alternative contract language
  • Exceptional understanding of Medicaid pricing, Medicare pricing, and CMS relativity
  • Clear and effective verbal and written communication

What the Team is Saying

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
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