In support of Optum's mission, vision, and strategic goals, this
position is responsible for oversight in the corporate Contract
Administration function which provides expertise, consulting and
administrative support for contracting team who supports network
staff. Reporting to the COO the VP leads the execution of
reimbursement strategies, value based contracting, analytics and
performance standards to enhance contractual relationships with key
multi-disciplinary healthcare partners; leads the negotiation with
diverse provider organizations; and ensures that contracting
tactics foster efficient and effective implementation through
delegated and contracted providers. The VP ensures that execution
aligns with strategic objectives coming from leadership
Major Responsibilities Serves as a strategic partner in the
development of the corporation’s plans and programs.
Advises the executive team on emerging trends and methodologies
in managed care contracting, payer relations and legal issues.
Develops overall payer and network contracting strategies for
business growth, maximum revenue and maximizing the organization’s
competitive cost structure.
Negotiates new contracts to ensure maximum revenue and
operational efficiency and compliance.
Establish the department's strategic vision, objectives, and
policies and procedures.
Develop, implement and maintain production and quality standards
for the Contracting department.
Work with Operational leaders to ensure effective implementation
and adherence of payment and authorization practices.
Establish and maintain effective business relationships with
network providers on behalf of the organization.
Perform periodic analyses of the provider network from a cost,
coverage, and growth perspective.
Conduct periodic review of provider contracting rates to ensure
strategic focus is on target with overall Company strategy.
Analyze claim trend data and/or market information to derive
conclusions to support contract negotiations.
Work with Managed Care providers and other representatives to
resolve contractual issues.
Support market expansion and MA activities by leading provider
contract analysis related to due diligence.
Oversees the creation and implementation of contracting training
programs for network staff.
Collaborates with legal to create non-standard contract language
when needed to support field contracting efforts.
Provides consulting, negotiations and contracting expertise to
field network staff as needed.
Participates in or support hospital and multi-site ancillary
provider contract negotiations as needed.
Participates in or support network development for new markets
Performs all other related duties as assigned.
Significant knowledge of provider contracting and reimbursement
Solid understanding of medical care delivery and financing
Ability to engage directly with senior level executives (e.g.,
CEO President, etc.).
Strong influencing skills, track record of successful client
relationship development and ability to quickly build credibility
and gain the confidence of individuals at all levels.
Exceptional interpersonal skills with ability to interface
effectively both internally and externally with a wide range of
people including physicians, office staff, hospital executives and
other health plan staff.
Excellent analytical and problem solving skills with effective
Strong verbal and written communication skills.
Proven contract negotiations skills.
Demonstrated ability to lead a service function through
influence management skills in a matrix management environment.
10 + years network development, provider negotiation and
contracting experience involving physicians, hospitals and
ancillary providers, including five or more years at the manager
level or above.
Bachelor’s degree in Business, Healthcare Administration or
related field required.
Master’s degree in Business, Healthcare Administration
Careers with Optum. Here's the idea. We built an entire
organization around one giant objective; make health care work
better for everyone. 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. Here you’ll
find incredible ideas in one incredible company and a singular
opportunity to do your life's best work. (SM)
Diversity creates a healthier atmosphere: Optum and its
affiliated medical practices are 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. Optum and its affiliated
medical practices is a drug-free workplace. Candidates are required
to pass a drug test before beginning employment.