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Associate Director of Network Programs - Remote PST
<p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">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 <strong>Caring. Connecting. Growing together.</strong></span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">So where are we today? The public and health care community are focused on the scope, diversity and quality of provider networks associated with health care products and coverage. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are composed and compensated. That means everything is open to new ideas and innovation. And your expertise in provider networks can help us build in the next phase of evolution. In this managerial role, you'll use your knowledge and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">You’ll enjoy the flexibility to work remotely * on the West Coast as you take on some tough challenges.</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Primary Responsibilities:</strong></span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Provides leadership to and is accountable for the performance of managers and/or senior level professional staff</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Impact of work is most often at the operational or local business unit or market level</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Owns an end-to-end process</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Develops functional, market level, and/or site strategy, plans, production and/or organizational priorities</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Identifies and resolves technical, operational and organizational problems outside own team</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Develops innovative approaches</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Serves as key resource on complex/critical issues</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Lead functional or segment teams or projects</span></li></ul><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Tactical Responsibilities:</strong></span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">West Region Direct Payer Network Point of Contact</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Project Manage Provider Bulletins that impact provider networks</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Liaison between Pricing Integrity, Contracting, Onboarding and Provider Relations ensuring “pay as the state pays” alignment with MassHealth regulations</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Liaison between provider network and Account Management team</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Ensure Network Reporting set up and maintenance</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Support benefit expansion initiatives</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Support network quality improvement initiatives</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Provider network readiness review</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Monitor performance guarantees</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Monitor emerging trends coming from provider-facing teams. Implement corrective action plans</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Establish and maintain Network policies and procedures to comply with regulatory and contractual requirements impacting provider network</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Regulatory and Customer audit – provider network deliverables</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">QBR participant</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Oversee trade org relationships</span></li></ul><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">This is an opportunity that will offer you challenge like no other. We operate a complex, matrixed business that requires you to work through ambiguity even as you build a relationship with some of our most focused and intense business leaders. You'll need to conceptualize effectively, communicate clearly and earn credibility within a demanding business environment.</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">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.</span></p><br><br><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Required Qualifications:</strong></span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">5+ years of provider relations experience</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">5+ years of supervisory level experience in a network management-related role handling complex network providers with accountability for business results</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">3+ years of experience with Medicare and Medicaid regulations</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Ability to call on Providers</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Intermediate level of knowledge of claims processing</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Demonstrated exceptional presentation, written and verbal communication skills</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Demonstrated proficiency in MS Word, PowerPoint, Excel, and Access</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Ability to travel up to 50%25</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Driver’s license and access to reliable transportation</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Dedicated, distraction-free workspace and access to high speed internet in home</span><br> </li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">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 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.</span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Application Deadline: </strong>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.</span><br> </p><p style="text-align:center;"><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i>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.</i></span></p><p style="text-align:center;"> </p><p style="text-align:center;"> </p><p style="text-align:center;"><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i>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.</i></span></p><p style="text-align:center;"><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i>UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</i></span></p>