1+ months

VP, Health System Strategic Partnerships - Telecommute in Houston, TX - 939157

Houston, TX 77002 Work Remotely
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  • Job Code
    939157

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your lifes best work.(sm)

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The Vice President of Health System Strategic Partnerships is responsible for the development of the Facility provider network yielding a geographically competitive, broad access, stable network that achieves objectives for quality and cost performance, achieves trend management objectives and produces an affordable and predictable product for customers and business partners. Evaluates and negotiates contracts in compliance with contract templates, reimbursement structure standards, and other key process controls. Establishes and maintains strong business relationships with Facilities, providers, and ensures the network composition is compliant with applicable network regulatory requirements.

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If you are located in Texas, preferably in the Greater Houston area, you will have the flexibility to telecommute* as you take on some tough challenges.

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Primary Responsibilities:

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  • Manage unit cost budgets, target setting, performance reporting and associated financial models
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  • Lead Joint Operating Committee meetings with facilities in conjunction with market leadership to ensure clear accountability for performance under contracts
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  • Ensure facility strategy effectively supports enterprise VBC strategies, payor strategies and reimbursement strategies for all products
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  • Collaborates with Market Presidents, Medical, Network, Operations and Financial teams to identify medical cost issues and develop remediation plans, including provider education and outreach, to address
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  • Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
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  • Performs all other duties as assigned
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Youll 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.

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Required Qualifications:

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  • Undergraduate degree or 10+ years of experience in a network management-related role handling complex network providers with accountability for business results
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  • 10+ years of experience working with a managed care organization or health insurer, or as a consultant, in a network/contract management role such as contracting, provider services, etc.
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  • 10+ years of experience with provider contracting
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  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs and Ambulatory Surgery Center Groupers
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  • Ability to travel nationally up to 25% based on business needs
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  • Reside in Texas - preferably in the Greater Houston area
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  • 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 similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • 15+ years of experience in a network management-related role handling complex network providers with accountability for business results.
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  • 15+ years of experience working with a managed care organization or health insurer, or as a consultant, in a network/contract management role such as contracting, provider services, etc.
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  • 15+ years of experience with provider contracting
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  • Excellent communication skills, including ability to communicate effectively with various levels of leadership
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Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

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WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy

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Diversity creates a healthier atmosphere: OptumCare is an 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.

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OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: VP Healthcare, Network Management, Provider Relations, Medicare Resource Based Relative Value System, RBRVS, Drugs And Ambulatory Surgery Center Groupers, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, TX, Texas

Posted: 2021-06-16 Expires: 2021-08-14

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, Health System Strategic Partnerships - Telecommute in Houston, TX - 939157

UnitedHealth Group
Houston, TX 77002

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