The Director, Network Strategy & Performance, is responsible for leading provider network strategy, performance, and operational oversight for the Rhode Island DSNP and Medicaid lines of business. This role is accountable for ensuring the health plan delivers a high-performing, compliant, and competitive provider network that meets access, affordability, and quality expectations.
This leader will partner closely with UnitedHealthcare National (UHN) network and contracting teams to influence network development and execution, while maintaining full accountability for market-level outcomes.
If you are able to travel to Rhode Island office at least 10% of the time based on business needs, you will have the flexibility to work remotely*, as well as work in the office as you take on some tough challenges.
Primary Responsibilities:Network Strategy & Market Leadership
- Lead development and execution of Rhode Island DSNP/Medicaid network strategy
- Identify network gaps and prioritize provider recruitment, expansion, and growth opportunities
- Align market strategy with enterprise network direction while ensuring local competitiveness
Network Adequacy & Regulatory Oversight
- Ensure compliance with federal and state network adequacy standards (e.g., time/distance, provider ratios)
- Lead audit readiness, regulatory submissions, and RFP-related network performance
- Serve as the accountable market leader for network compliance and access outcomes
Network Performance & Improvement
- Monitor network performance across access, quality, cost, and provider experience
- Drive action plans to address network gaps, provider access issues, and performance risks
- Partner with enterprise teams to advance value-based and performance-driven strategies
Enterprise Partnership (Network Contracting)
- Partner with UHN and contracting teams to influence provider recruitment and network build priorities
- Guide contracting strategy by translating Rhode Island market needs into actionable priorities
- Ensure alignment between enterprise execution and local network strategy
Provider Experience & Engagement
- Lead provider engagement strategy to improve satisfaction and ease of doing business
- Identify and address provider friction points and escalation trends
- Strengthen provider advocacy and support models in partnership with enterprise teams
Cross-Functional Leadership & Growth
- Lead network-related initiatives across health plan, clinical, compliance, and enterprise partners
- Support DSNP growth strategy and market expansion efforts
- Ensure a competitive, locally differentiated network aligned to Rhode Island market needs
You9ll 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:- 8+ years of healthcare experience, including provider network management
- 5+ years of leadership experience in a matrixed organization
- Experience leading complex, cross-functional initiatives
- Medicaid and/or DSNP programs
- Provider network strategy and performance
- CMS and state regulatory requirements
- Ability to travel to the Warwick office at least 10% of the time based on business need
Preferred Qualifications:- Experience working in a model partnering with enterprise network/contracting teams (UHN/PROS)
- Experience supporting RFPs, network builds, or new market expansion
- Experience with Rhode Island Medicaid and/or DSNP programs
- Background in value-based care or provider performance management
*All employees working remotely will be required to adhere to UnitedHealth Group9s Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you9ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 - $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ
