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Vice President, Network Contracting - Southern California

UnitedHealth Group

Cypress, CA
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Job Details

757316 Vice President Network Contracting Southern California

Vice President, Network Contracting - Southern California (757316)

Position Description

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)


The Vice President, Network Management within the Southern CA Region develops the provider network (physicians, hospitals, and/or ancillary providers, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. The Vice President, Network Management - Southern CA Region evaluates and negotiates contracts to ensure compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties, in order to meet regulatory minimum network adequacy requirements.


Primary Responsibilities:

  • Develop, translate and execute strategies or functional / operational objectives for a region, line of business (Commercial, Medicare, and Medicaid / MediCal)
  • network configuration and incentive-based payment models as appropriate to improve quality and efficiency

  • Direct others to resolve highly complex or unusual business problems that affect major functions or disciplines

  • Drive programs that impact markets of customers ranging from providers, employers and/or consumers.

  • Drive and execute Northern California network strategies including strategic partnering with key Tier 1 providers

  • Strong working knowledge of Value Based contracting strategies is critical including experience with ACO's

  • Knowledge in building new networks and product configurations

Required Qualifications:

  • Undergraduate degree or equivalent experience
  • 10+ years of experience in a network management - related role handling complex network providers with accountability for business results

  • 10+ years of experience in the health care industry

  • 4+ years of experience in developing of product pricing and utilizing financial modeling in making rate decisions

  • Management experience

  • 5+ years of experience developing and managing a medical cost and administrative budget

  • 5+ years of experience with provider contracting

  • Advanced level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, Performance Based Contracting, etc.

  • Proven experience executing executive verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others, including but not limited to reimbursement policy standards

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM

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.
Job Keywords: network management, health care industry, product pricing, financial modeling, provider contracting, Cypress, CA, San Diego, CA, California


Job Details

  • Contest Number757316
  • Job TitleVice President, Network Contracting - Southern California
  • Job FamilyNetwork Contracting and Pricing
  • Business SegmentUnitedHealthcare Networks

Job Location Information

  • Cypress, CA
    United States
    North America
  • Other LocationsSan Diego, CA

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelDirector
  • ShiftDay Job
  • TravelYes, 25 % of the Time
  • Telecommuter PositionNo
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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