1+ months

VP, Government Programs Network Payment Strategies - Telecommute - 902208

Minnetonka, MN 55345 Work Remotely
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  • Job Code
    902208

Here at UnitedHealth Group, when you join our leadership team, you'll be surrounded by focused, performance driven leaders who have helped us build our global strength and incredible momentum. With the help of leaders like you, we're driving higher levels of sophistication in how provider networks are composed and compensated. In this role, you'll provide direction and guidance to the development of provider networks using your knowledge and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 7 leader.


This is a key leadership role on the Government Programs Network Strategy team responsible for developing and evolving all value-based payment programs for Medicare Advantage (MA), Dual Special Needs Plans (DSNP), Medicaid and Individual Exchange (IEX). The Vice President ofGovernment Programs Network Payment Strategies leads a team of about 30 employees, managing over 1 billion of annual provider incentive payments across many value-based models.


You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.


Primary Responsibilities:

  • Continue to develop, deploy and measure effectiveness of the following types of ValueBased Contracting (VBC) models:
    • Global/professional/split capitation & delegation
    • PCP Capitation
    • Retrospective full risk
    • Shared savings/risk ACO
    • PCP Stars and diagnosis capture incentives
    • Bundled/Episodic payments
    • Surgeon site of service optimization
    • Hospital based physician (HBP) incentives
    • Home health
    • Target population shared risk (palliative, CKD/ESRD, etc.)
  • Develop new payment models to address performance variation and meet Line ofBusiness affordability and revenue objectives
  • Coordinate across functional areas of UHG to design payment models to achieve clinicalperformance outcomes/KPIs, ensure compatibility with other programs, and operationalize programs efficiently
  • Lead the training and assistance to network contractors in markets to successfullycontract VBC models and address key provider objections
  • Deploy competitive analysis on provider incentive and VBC programs used by otherhealth plans and use to direct UHC strategy and programs
  • Lead bundled payments programs for CMS BPCI-A, Medicare Advantage andCommercial, and manage our relationship with CMS bundle partner Episode Solutions (continued growth in the $20M revenue/savings from bundled payments)
  • Deploy VBC to help build new Medicaid and IEX networks
  • Develop models to ensure avoidance of minimum VBC penalties and maximize qualityincentives/withholds form state clients
  • Lead Primary Care payment strategy and ensure complete spectrum of financial models for all types of primary care practices and manage national relationships with strategicPrimary Care partners to optimize growth and performance
  • Responsible for developing payment/incentive models for provider and caremanagement partners such as Aspire and Prospero for palliative, DaVita and Somatus for chronic kidney disease and ESRD, Optum/Vivify/Navi for post-acute, MyNexus and NaviHealth for home health, etc.
  • Manage capital investment agenda for advancing payment model capabilities
  • Requires working closely with Region/Market CEOs, Clinical, Finance and HCE toevaluate VBC performance and continually improve effectiveness
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:

  • Bachelor's degree or equivalent work experience
  • 10+ years of experience working with a managed care organization, health insurer, or as a consultant in a network/contract and value-based model management role
  • 10+ years of experience managing staff and at least 8 years of project management or project lead experience
  • Strong strategic, analytic and critical thinking skills with proven ability to analyze data to identify opportunities, inform program design and measure process and financial outcomes
  • Demonstrated ability to inform design, build and implement provider value-based reimbursement models and incentives
  • Work with market LOB and network leadership to train and facilitate contracting of value-based models
  • Demonstrated ability to transform care models, engage members and providers and succeed in risk-based and alternative payment models
  • Effective strategic and critical thinking skills needed to focus on actionable information and drive results
  • Proven ability to drive, lead and communicate change effectively in a fast-paced environment and be adaptable within the changing environment
  • Ability to manage programs and projects in a strategic and professional manner
  • Ability to manage and support organizational change and help assist individuals through the transition
  • Strong ability to communicate effectively and efficiently (both verbal and written) at multiple levels of large, complex organizations
  • Motivate and influence others at all levels within the organization
  • Strong history of quickly building relationships, gaining credibility and partnering with business leaders. Must excel at building teams and collaborating across multiple distinct business groups
  • Excellent communication skills, including ability to communicate effectively with various levels of leadership
  • You will be required to adhere to UnitedHealth Group's US Telecommuting Policy.
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.

Preferred Qualifications:

  • Post graduate degree
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 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: Minnesota, MN, Telecommute, Remote, Work from Home

Posted: 2020-11-28 Expires: 2021-01-28

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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VP, Government Programs Network Payment Strategies - Telecommute - 902208

UnitedHealth Group
Minnetonka, MN 55345

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