For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
As the Director, you represent the voice of our complex, large scale, strategic Providers to the rest of organization. You are accountable for the full range of Behavioral Health provider relations and service interactions. These include managing the ongoing contract relationship and service delivery, working on end-to-end provider claim issues, promoting use of physician portal and soliciting future service enhancements, and training & development of external provider education programs. You'll design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.) and practice managers.
If you are located in Florida, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
Represents the voice of our providers to the rest of the organization and is measured on Provider NPS
Acts as outward-facing, dedicated resource for assigned large scale national health systems and / or strategic providers across network management, provider relations, contracting, network adequacy, value based initiatives and performance analytics
Acts as SME on complex contract requirements which may vary by facility within large scale, national systems
Builds relationships with key providers and serves as primary point of contact for overall and day-to-day Behavioral Health provider relations and service interactions
In cases where key providers are shared across UHC Medical and Behavioral Health networks, collaborates with UHN provider relations team to deliver an integrated provider experience
Serves as a centralized intake point for provider inquiries and claim issues Oversees inquiry and complex issue resolution based on a comprehensive understanding of contractual agreement spanning all entities / service locations for the respective national system and / or strategic providers
Develops a strategic partnership that enables best practice sharing as well as collaboration on innovation
Manages high level provider health systems and direct clients regarding escalations
Knowledge of policies and procedures
Experience with RFPs, presentations, deliverables and reporting
Anticipates provider needs and proactively develops solutions to meet them
Navigates and influences multiple cross-functional teams in a complex, matrix work environment
Provides explanations and information to others on the most complex issues
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:
7+ years of network management, contracting and or provider relations experience
Direct supervisory experience of 10+ staff
Demonstrated ability to achieve goals in a matrix environment
Proficiency with MS Office applications
Located in the state of Florida with the availability and willingness to travel up to 25% (quarterly)
Preferred Qualifications:
Performance population health analytics experience
Policy and procedure experience
Behavioral Health experience
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
