Director UMR Network Contracting and Solutions - Remote

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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Reporting to the VP Customer Solutions – Ancillary, Networks and PBM, the Director, Network Contracting Manager is responsible for the strategy, development, implementation and management of UMR’s out-of-network (OON), payment integrity (PI) and customer network management solutions.  These solutions are critical to UMR’s ability to control customer/member costs and meet customer needs to grow and retain business.Custom Network Management:  Customer specific and secondary network contracting to support growth and retention.  Credentialing and directory solutions that support custom client solutions including some of UMR’s largest customers (Bon Secours, State of WV, Advocate Aurora, etc.) as well as internal network solutions.Payment Integrity:  Development/Enhancement of UMR’s Payment Integrity solutions/strategy, including pricing and custom solutions.  Supporting/Managing to the network requirements for PI, including external vendors.  UMR’s PI programs support ~3M members and is growing, driving ~170M+ in savings to members/clients in 2024.Out-of-Network:  Development/Enhancement of UMR’s OON solutions/strategy, including pricing and custom solutions.  UMR’s OON solutions support most of our 7.4M members, driving ~$1.4B in savings to members/clients in 2024.You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.   Primary Responsibilities: Leading OON, PI and customer network management initiatives (directing and engaging in provider contracting and directory activities) including setting procedural standards and optimizing operational processesProviding leadership, coaching and training to team members, assigning projects, and ensuring quality control and timely turnaroundManaging daily operations of multiple levels of staff and multiple functions across various business units to support OON, PI and customer management solutionsUnderstanding market and customer trends related to OON, PI and customer management solutions and developing solutions to addressMonitoring performance trends and collaborating with stakeholders to enhance operational efficiency and solution performanceAnalyzing financial impact and performance trends, developing projections, and monitoring and managing program budgetsDeveloping and maintaining business/contractual relationships with vendors while managing their operations to ensure compliance with key performance indicators and service level indicatorsIdentifying and securing resources required to implement, maintain and enhance solutionsMaintaining solid relationships and engaging with internal and external partners to support growth and retentionYou’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 experience in healthcare industry2+ years of experience in leadership role within the healthcare industryExperience in managing direct reportsPreferred Qualifications:Experience with provider contracting, out of network and payment integrityProven solid organizational and analytical skillsProven ability to lead a team, provide management and coaching, and interact with senior executives and customers on strategy, custom requests, pricing, operations, and solution performanceProven ability to develop, implement and manage programs in a strategic and professional mannerProven ability to communicate effectively and efficiently internally and externallyProven ability to develop and maintain solid business relationships*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.  The salary range for this role is $124,500 to $239,400 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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.    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.   Brand: Employer & IndividualJob ID: 2258141Employment Type: Full-timeJob Area: Network Contracting & PricingFunction: GeneralIndustry: Direct Health/Medical Insurance Carrier