Vice President - Payer Strategy and Contracting - Remote
Opportunities with Optum in the Tri-State region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind Caring. Connecting. Growing together.
The Vice President - Payer Strategy & Contracting provides leadership, direction and oversite of fee for service and value-based contracting across the Tri-State. This person is responsible for the strategic planning and financial measurement of the payer contracts with both current and future prospective health plans.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
- Leads payer negotiations for both traditional fee-for-service and value-based arrangements, including reimbursement terms and contract language
- Collaborates with Executive Leadership to develop contracting strategy to optimize the fee-for-service revenue and develop reimbursement models to support the transition to value-based care
- Manages payer relations and keeps up to date on regulatory and policy changes
- Oversees ongoing review and renewal of existing payer contracts
- Collaborates with Optum’s National Payer and HCE teams to ensure we are aligned on strategy and data analytics
- Leads the implementation and use of expected reimbursement models and tools to support revenue forecasting, recovery of underpayments, and advanced cost estimates
- Oversees the charge master updates to ensure our professional fees are aligned with our reimbursement rates
- Coordinates with our revenue cycle partner to ensure contracts are administered correctly based on the contract terms and policy updates
- Collaborates with finance leadership to communicate trends and impact of payer contract changes
- Oversee insurance payer settlement calculations and agreements
- Evaluation of CMS rate and policy updates and assessment and communication to executive leadership of financial impact
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.
- Bachelor's Degree in Business or Health Administration or related field
- 7+ years of experience in managed care contracting and reimbursement
- 5+ years of managerial experience
- Extensive knowledge of managed care contracting language
- Proficiency in Microsoft Excel, Word and PowerPoint
- Proven solid leadership and interpersonal skills
- Proven exceptional verbal and written communication skills
- Proven excellent professional presentation and organization skills, including ability to manage an array of people, contracts, and deadlines
- MBA or Masters Degree
California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $118,000 to $226,800. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.
*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: 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.