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Job Description - RVP Network Contracting - California and Hawaii (2372692)

RVP Network Contracting - California and Hawaii - 2372692

At UnitedHealthcare,we’resimplifying the health care experience, creating healthiercommunitiesand removing barriers to quality care. The work you do hereimpactsthe lives of millions of people for the better. Come build the health caresystem oftomorrow, making it more responsive,affordableand optimized. Ready to make a difference? Join us to startCaring. Connecting. Growing together.

The Regional Vice President of Network Contracting reports to the West States Senior Vice President and is responsible for leading the California and Hawaii markets.

This market leader will represent UnitedHealthcare for all lines of business covering Commercial, Medicare, Medicaid and Exchange products, supporting all provider reimbursement types from fee-for-service to capitated arrangements. This role drives performance against affordability, network stability, and growth objectives while maintaining strong executive-level relationships with key health systems and provider organizations. The RVP serves as the senior market leader accountable for network strategy execution, cross-functional alignment, and team performance across one of UHC’s most complex and high-impact markets. In addition, this leader will need to help develop, design, and manage unique network configurations within each of these business lines to ensure growth and performance of each network meeting UHC needs. Additionally, market leaders build, attract, and develop a best in class performing network contracting team while working with all other UHC teams. The RVP ensures achievement of key performance metrics, including trend, adequacy, and access, ensuring contracting compliance with regulatory requirements, particularly in the heavily regulated California environment.

Primary Responsibilities:

Develop, design, and manage the medical network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) to yield a geographically competitive network that achieves objectives for unit cost performance and trend management and produces an affordable, predictable product for customers and business partners. As market leader, you will oversee all lines of business to meet the unique expectation of each business lines’ needs

Hire, develop, and retain a high performing contracting team working across company departments to ensure MBOs are met

Lead the local team while also responsible for ensuring all medical contracts are in compliance with UnitedHealthcare’s contract templates and standards, meeting state and federal regulatory requirements

Establish reimbursement structure standards and other key process controls

Ensure the network composition includes an appropriate distribution of provider specialties for each line of business and includes multiple narrow network products

Lead and develop market strategies and visions across multiple lines of business

Develop, translate, and execute business strategies and objectives for respective markets in the California and Hawaii markets for all lines of business

Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency

Lead a large multi-state team, setting expectations for strategy development, performance accountability, talent development and succession planning

You’llbe 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:

Bachelor’s degree or equivalent experience

10+ years of experience in a network management-related role managing complex network provider systems

10+ years of contracting experience in Network / Provider Management

8+ years of healthcare experience

8+ years of experience in product pricing, financial modeling, and managing a market budget

5+ years of supervisory experience

Experience negotiating capitated, value-based and fee for service arrangements a must

Proven ability to communicate network strategy and drive results

Ability to successfully function in a matrix organization

Ability to successfully leverage relationships both internal and external

Solid independent decision-making skills to drive sound, quality results in a timely manner

Solid ability to operate and influence across the enterprise to drive critical decisions and execution

Demonstrated broad-scope financial expertise

You will be asked to perform this role in an office setting or other company location

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 $200,400 to $343,500 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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,locationand 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 marginalizedgroupsand those with lower incomes. We are committed to mitigating our impact on the environment and enabling and deliveringequitablecare that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

UnitedHealth Group is adrug -free workplace. Candidatesare required topass a drug test before beginning employment.

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

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.