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UnitedHealth Group Associate Director of Healthcare Provider Network Contracting - Georgia in Atlanta, Georgia

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Associate Director of Network Contracting develops the provider network (physicians, hospitals, pharmacies, ancillary, 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. The role evaluates and negotiates 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.

This role covers the Southeast region and does include provider visitation and presentations.

If you are located in the state of Georgia or a boarding state, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Evaluate and negotiate contracts in compliance with company contract templates, and other key process controls

  • Work directly with the UHN Market Lead and Provider Relations Lead to understand necessary contracting and provider education activities related to state specific initiatives

  • Complete ad hoc data analysis to support inquiries from Community and State segment leaders, compliance, or the state regulators

  • Set up reoccurring meetings with key Community and State leaders to review items that require action and execution by UHN market

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 the Healthcare industry with Managed Care

  • 5+ years of experience with Provider Contracting, preferably with Tier One / Hospital / ACO providers

  • 4+ years of experience with Medicaid and Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRG's, Ambulatory Surgery Center Groupers, etc.

  • 4+ years of experience leading or contributing to projects

  • 3+ years of experience developing and delivering presentations to mid or senior level provider staff

  • Intermediate level of proficiency with MS Excel, PowerPoint and Office Software

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

  • 5+ years of experience in contributing to the development of product pricing and utilizing financial modeling in making rate decisions

  • Experience with UHN/UHC process, provider contracting and payment reform models (episodes, PCMH, ACO)

  • Experience in population health and clinical transformation

  • Currently residing in the state of Georgia

  • Ability to work effectively in an ambiguous environment

  • Ability to communicate effectively with various levels of leadership

  • Advanced negotiation skills; ability to gain acceptance from others on a plan or idea and achieve bottom line results for the company

  • Comfortable taking ownership and accountability for projects

  • Excellent relationship and communication skills (verbal and written)

  • Great relationship skills, be a very strategic thinker, takes an optimistic approach to challenges, and a team orientated individual

  • Strong customer service skills

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that’s second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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 drugfree workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Associate Director of Network Contracting, Network Contracting, Atlanta, GA, Georgia, Work At Home, Remote, Work From Home, Telecommute, Telecommuter, Telecommuting, UHG, UnitedHealth Group, UHC, UnitedHealthcare