Remote Associate Director, Network Contracting

Optum; New York (NY); Remote; USD 113,000 - 193,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock purchase

401k contribution

Job summary

Optum is seeking an Associate Director, Network Contracting to guide provider network development and unit cost management through pricing modeling, analysis, and reporting. You will build a competitive, broad-access network and ensure affordable product design for customers and partners.

The role requires 5+ years in network management, 2+ years in cost/affordability work, and strong Medicare/Managed Care knowledge.

Qualifications

• 5+ years in a network management-related role handling complex network providers with accountability for business results.
• 2+ years of medical cost and affordability experience.
• 2+ years of experience with provider contracting and/or provider network management.
• Experience using financial models and analysis to negotiate rates with providers.
• Proven solid knowledge of Medicare and Managed Care Reimbursement.

Responsibilities

• Balance financial and operational impact of contracts to providers, members, UHN, and different customer groups when developing and/or negotiating contract terms.
• Develop functional, market level and/or site strategy, plans, production and/or organizational priorities.
• Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency.
• Demonstrate understanding of applicable products for different lines of business (Employer and Individual; Medicare and Retirement; Community and State).
• Evaluate current contract performance to identify potential remediation opportunities and/or cost savings.
• Demonstrate understanding of and utilize applicable financial tools and reports to evaluate performance of current contracts.
• Demonstrate understanding of contract language to assess financial and operational impact and legal implications of requested contract changes.
• Demonstrate understanding of competitor landscape within the market (rates; market share; products; provider networks; market intelligence; GeoAccess).
• Represent department in external meetings to gather relevant information, recommend solutions, execute on deliverables as assigned and explain results/decision/activities.
• Develop and/or implement contracting strategies to support new benefits designs and plans.

Skills

Network management

Cost analysis

Provider contracting

Financial models

Medicare knowledge

Travel readiness

Job description

Optum is seeking an Associate Director, Network Contracting to guide provider network development and unit cost management through pricing modeling, analysis, and reporting. You will build a competitive, broad-access network and ensure affordable product design for customers and partners.

The role requires 5+ years in network management, 2+ years in cost/affordability work, and strong Medicare/Managed Care knowledge.