RVP Network Contracting - California and Hawaii

Posted 4 Hours Ago
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Cypress, CA, USA
In-Office
200K-344K Annually
Expert/Leader
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Lead California and Hawaii network contracting across Commercial, Medicare, Medicaid and Exchange lines. Design and manage provider networks, reimbursement structures, and value-based arrangements. Build and lead a multi-state contracting team, ensure regulatory compliance, meet cost and access metrics, and drive cross-functional alignment to achieve market growth and performance.
Summary Generated by Built In
Requisition Number: 2372692
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The Regional Vice President of Network Contracting reports to the West States Senior Vice President and is responsible for leading the California and Hawaii markets.
This market leader will represent UnitedHealthcare for all lines of business covering Commercial, Medicare, Medicaid and Exchange products, supporting all provider reimbursement types from fee-for-service to capitated arrangements. This role drives performance against affordability, network stability, and growth objectives while maintaining strong executive-level relationships with key health systems and provider organizations. The RVP serves as the senior market leader accountable for network strategy execution, cross-functional alignment, and team performance across one of UHC's most complex and high-impact markets. In addition, this leader will need to help develop, design, and manage unique network configurations within each of these business lines to ensure growth and performance of each network meeting UHC needs. Additionally, market leaders build, attract, and develop a best in class performing network contracting team while working with all other UHC teams. The RVP ensures achievement of key performance metrics, including trend, adequacy, and access, ensuring contracting compliance with regulatory requirements, particularly in the heavily regulated California environment.
Primary Responsibilities:
  • Develop, design, and manage the medical network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) to yield a geographically competitive network that achieves objectives for unit cost performance and trend management and produces an affordable, predictable product for customers and business partners. As market leader, you will oversee all lines of business to meet the unique expectation of each business lines' needs
  • Hire, develop, and retain a high performing contracting team working across company departments to ensure MBOs are met
  • Lead the local team while also responsible for ensuring all medical contracts are in compliance with UnitedHealthcare's contract templates and standards, meeting state and federal regulatory requirements
  • Establish reimbursement structure standards and other key process controls
  • Ensure the network composition includes an appropriate distribution of provider specialties for each line of business and includes multiple narrow network products
  • Lead and develop market strategies and visions across multiple lines of business
  • Develop, translate, and execute business strategies and objectives for respective markets in the California and Hawaii markets for all lines of business
  • Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
  • Lead a large multi-state team, setting expectations for strategy development, performance accountability, talent development and succession planning

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:
  • Bachelor's degree or equivalent experience
  • 10+ years of experience in a network management-related role managing complex network provider systems
  • 10+ years of contracting experience in Network / Provider Management
  • 8+ years of healthcare experience
  • 8+ years of experience in product pricing, financial modeling, and managing a market budget
  • 5+ years of supervisory experience
  • Experience negotiating capitated, value-based and fee for service arrangements a must
  • Proven ability to communicate network strategy and drive results
  • Ability to successfully function in a matrix organization
  • Ability to successfully leverage relationships both internal and external
  • Solid independent decision-making skills to drive sound, quality results in a timely manner
  • Solid ability to operate and influence across the enterprise to drive critical decisions and execution
  • Demonstrated broad-scope financial expertise
  • You will be asked to perform this role in an office setting or other company location

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 $200,400 to $343,500 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 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.
UnitedHealth Group is 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 is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • Bachelor's degree or equivalent experience
  • 10+ years in network management-related roles managing complex provider systems
  • 10+ years of contracting experience in Network / Provider Management
  • 8+ years of healthcare industry experience
  • 8+ years experience in product pricing, financial modeling, and managing a market budget
  • 5+ years of supervisory experience
  • Experience negotiating capitated, value-based, and fee-for-service arrangements
  • Proven ability to communicate network strategy and drive results
  • Ability to successfully function in a matrix organization
  • Ability to leverage internal and external relationships effectively
  • Strong independent decision-making skills to deliver timely, quality results
  • Ability to operate and influence across the enterprise to drive decisions and execution
  • Demonstrated broad-scope financial expertise
  • Perform role in an office setting or other company location (on-site work)

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Leave & Time Off Breadth PTO accrues each pay period with eight paid U.S. holidays plus a floating holiday, and generous time away is consistently emphasized. This breadth supports planned and unplanned time off beyond standard vacation days.
  • Parental & Family Support Six weeks of paid parental leave, up to two weeks of paid caregiver leave, Bright Horizons back‑up care, and adoption assistance signal strong family-oriented support. EAP access with counseling sessions further extends help to employees and their households.
  • Wellbeing & Lifestyle Benefits Company‑paid short‑ and long‑term disability, Calm app membership, tuition reimbursement, commuter and FSA accounts, and broad employee discounts expand everyday wellbeing resources. Free or low‑cost virtual visits complement these lifestyle supports.

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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
Metro Manila, Philippines
Cebu, Philippines
Davao, Philippines
Ann Arbor, MI
Atlanta, GA
Baltimore, MD
Bengaluru, India
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Hyderabad, India
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Madison, WI
Minneapolis, MN
Nashville, TN
New Delhi, India
Philadelphia, PA
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Raleigh, NC
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