Provider Network Director — Remote Leadership

UnitedHealth Group; Boise (ID); Remote; USD 113,000 - 193,000; Full time

Benefits offered by this job

Benefits package

Incentive programs

Equity stock purchase

401(k) contribution

Job summary

UnitedHealthcare is seeking a Network Director to lead provider engagement and network adequacy initiatives across Idaho, with remote flexibility. The role focuses on building strong relationships between the health plan, providers, and practice managers while improving end-to-end provider experiences, including service interactions and regulatory reporting.

The position requires extensive experience in provider networks and Medicaid/Medicare, with the ability to manage multiple initiatives,

Qualifications

• 5+ years of Provider Network Relationship Experience.
• 4+ years Medicaid and/or Medicare experience.
• 4+ years of project management experience.
• 4+ years of direct communication with Regulators.
• Understanding of the Medicaid contracting process, including downstream agreements.
• Intermediate proficiency with MS Word, Excel, and PowerPoint.
• Proven ability to establish and monitor key performance indicators.
• Proven ability to meet deadlines.
• Proven ability to influence course of action when other teams are accountable for outcomes.

Responsibilities

• Manage provider complaints to resolution when initiated through regulators and report status updates to IDHW and providers as needed.
• Proactively partner with providers to identify opportunities for improvement, growth, collaboration, and to gain general feedback regarding provider experience.
• Partner with the COO to investigate and solve operational challenges, maintaining a consultative and collaborative approach with providers through resolution.
• Engage in onsite visits with providers, utilizing data analysis to determine which providers should be visited.
• Manage regulatory reports for the Idaho network and partner with technical and functional teams to compile and audit reports.
• Oversee HCBS Provider Advocates, Workforce Development Administrator, Credentialing Coordinator, and Provider Claims Educator, providing coaching, mentorship, auditing, monitoring, and career development.
• Facilitate monthly meetings with all provider-facing teams, including provider relations, network contracting, growth, quality, and subcontractor provider teams.
• Attend key provider conferences and lead subcontractor provider network meetings.
• Lead and facilitate meetings with providers and provider groups, including IHA and other provider meetings where regulators are present.
• Contribute to advisory committees and demonstrate leadership and subject-matter expertise about our provider experience.
• Build relationships with credentialing, contracting, and provider education teams.
• Assist providers in adopting enterprise tools that reduce administration, including POCA.
• Monitor Provider NPS with a focus on improvement.
• Oversee provider communications, including management of the annual provider manual, quarterly newsletter production, and monthly provider website reviews.
• Attend Call Calibration sessions to understand provider experience and provide coaching to the customer service team.
• Act as a subject-matter expert regarding contract obligations related to the network.
• Meet with IDHW and other regulatory points of contact, focusing on relationship building and transparency.
• Consistently monitor network adequacy through Geo-Access reports and partner with UHN and other network teams to fill gaps.
• Collaborate with the Member Engagement Coordinator to solicit member feedback around provider experience and network gaps.
• Work with the SDoH Navigator and Population Health team to drive Health Equity initiatives and SDoH goals within the provider network.
• Partner with UHC and other functional areas on Value Based Contracting opportunities and execution.
• Represent UHC in in-person provider meetings and IDHW Provider Forums, traveling within ID at least 25% of the time.

Skills

Provider relations

Medicaid/Medicare experience

Project management

Regulator communications

KPI tracking

Deadline driven

Cross-functional collaboration

Tools

MS Word

Excel

PowerPoint

Job description

UnitedHealthcare is seeking a Network Director to lead provider engagement and network adequacy initiatives across Idaho, with remote flexibility. The role focuses on building strong relationships between the health plan, providers, and practice managers while improving end-to-end provider experiences, including service interactions and regulatory reporting.

The position requires extensive experience in provider networks and Medicaid/Medicare, with the ability to manage multiple initiatives,