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Job Details

UnitedHealth Group

Director of Provider Network Strategy and Provider Contracting Consultant - Telecommute (111777663)

Sales and Marketing




Eden Prairie, Minnesota, United States

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

You’ve been working your way to this opportunity for some time now. Now that you’ve learned to lead and build a deep expertise in health care network operations, it is time to set your sights on having more impact in more ways. Join our leadership team and help UnitedHealth Group meet the challenge of shaping where health care will go. As a leader within our network contracting team, you’ll help to guide the development and support of provider networks as well as delivery for our payer clients for network expansion, provider performance, contract operations and provider operations. As you do, you’ll find that you can make a real impact while enjoying the resources, backing and opportunities that you’d expect from a Fortune 5 leader. This position will be within our Optum Advisory Services where we provide Provider Network Consulting support to payers across the country.

The Director of Provider Network Strategy & Provider Contracting Consultant is responsible for the successful driving overall provider network program prioritization, strategic planning and product execution for our payer clients. This includes end to end network management solutions from provider network development/expansion, provider network performance management, compensation model design and provider operations. The Director will be the lead for assessment and evaluation and support design of strategy for new initiatives, approaches or solutions related to provider network management and contracting. The right candidate will have experience managing complex provider network initiatives for health plans to mitigate risk, improve the quality and affordability and remediate gaps in provider performance.

The Director will develop and drive implementation of large scale complex provider network strategies for payers across the country to include: network development and expansion roadmaps, network design, network performance optimization, provider initiatives, and provider data operational efficiencies.

Optum is a leader in supporting innovative network design strategies and provider contracting arrangements. We help payers build strategies to reach their goals for network expansion, optimal provider contracts and provider performance and effect provider operations.

This Director is responsible for the design, development, delivery and business development of consulting services in support of provider network strategies, market area and line of business provider expansion, provider operations, and advanced payment models.

If you are located in Eden Prairie, MN, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Work with payer clients and cross functional teams to lead Provider Network initiatives to ensure on time delivery of projects to exceed client expectations in a fast paced, performance driven environment
  • Research strategic initiatives/process to assimilate information in a manner to allow for both quantitative and qualitative interpretation to help lead or define the scope, identification of known processes or issues, and create a forward-looking strategy or process to advance payer client busines goals
  • Work with analytics to guide the development of provider performance initiatives to realize improved medical cost, quality, provider performance. Demonstrate expertise in network performance management/ cost of care provider initiatives
  • Lead and develop provider network strategies for focused areas such as expansion, provider performance, incentive design development, provider operations across multiple lines of business
  • Develop, translate, and execute provider network and contracting strategies and objectives for payer clients
  • Identify and solve problems that impact the management and direction of the business
  • Develop plans that impact the long-term success of the business
  • Influence senior management decisions that impact business direction
  • Has segment-wide and/or enterprise-wide impact
  • Direct cross-functional and/or industry-wide teams
  • Create supporting collateral and support sales effort with Network Practice
  • Provide leadership relative to solution ideation, creation, development, and implementation
  • Provide project management oversight for large initiatives
  • Lead and coordinate analytic activities (analyses and report creation)
  • Lead fast paced projects for on time delivery
  • Provide general healthcare consulting services
  • Achieving specific revenue and IOI targets while collaborating with other consulting activities within Optum Advisory Services
  • Lead client teams to deliver a variety of services relating to provider network management including ensuring performance guarantees of contracts are reached
  • Ensure quality and performance are established and measured with improvement goals developed
  • Business and Practice Development (~25% Time Allocation):
    • Define the business development strategy for a subset of the practice, as required
    • Own and manage sales accounts, leads, pursuits, and proposals
    • Identify and own the development of new Network Management & Provider Operations consulting solutions that will be brought to market, leveraging research and internal resources
    • Effectively build and maintain relationships with internal and external clients
    • Identify opportunities for sales and business development collaboration with other Optum business segments
    • Develop thought leadership and share point of view in various mediums
  • Program Delivery and Oversight (~75% Time Allocation):
    • Direct responsibility for the delivery oversight of large scale program execution
    • Large scale network programs are defined as high cost, high complexity and/or high risk
    • Facilitate development of business segment and enterprise level planning and program objective setting
    • Provide strategic input to the development of program roadmap and timelines
    • Create a team oriented work climate that enables professional development and encourages creative solutions and strategies
    • Support the management of resources within programs
    • Support program communication plan and execution
    • Require that quality assurance methods are implemented within the program
    • Provide status updates and review of programs to senior leadership
    • Provide coaching and mentoring of project team with the goal of developing and retaining talent within the organization

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:

  • Undergraduate degree
  • 10+ years of management experience in a network management-related role handling complex network providers with accountability for business results
  • 8+ years of experience in developing of product pricing and utilizing financial modeling in making rate decisions
  • 5+ years of experience developing and managing a medical cost and administrative budget
  • 5+ years of experience with provider contracting
  • 5+ years of experience leading large-scale/enterprise wide projects or large internal provider network healthcare projects/programs
  • Experience with business development
  • Experience leading a team
  • Professional competence in Microsoft PowerPoint, Word, Excel and Access
  • Ability to travel up to 75%
  • Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance

**Typical travel scenario - Travel is based on project size, scope and location. Projects may require up to 75% travel. If travel is required, typical travel schedule is out early Monday, back late Thursday with telecommute from home on Friday.

Preferred Qualifications:

  • Solid interpersonal, communication, presentation and meeting facilitation skills
  • Proven analytical and problem-solving skills, including ability to develop/recommend solutions through research and analysis of data and business process and implement when appropriate
  • Ability to define a problem statement, form hypotheses and request appropriate analysis to support the decision making and advisory process
  • Ability to work collaboratively with external and internal constituents gaining consensus/support and managing stakeholder input/approval
  • Ambitious self-starter with comfort navigating ambiguous situations and problems

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to 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 drug-free workplace. Candidates are required to pass a drug test before beginning employment.