The Regional Vice President of Network Contracting reports to the West States Senior Vice President and is responsible for leading the California and Hawaii markets.
This market leader will represent UnitedHealthcare for all lines of business covering Commercial, Medicare, Medicaid and Exchange products, supporting all provider reimbursement types from fee-for-service to capitated arrangements. This role drives performance against affordability, network stability, and growth objectives while maintaining strong executive-level relationships with key health systems and provider organizations. The RVP serves as the senior market leader accountable for network strategy execution, cross-functional alignment, and team performance across one of UHC's most complex and high-impact markets. In addition, this leader will need to help develop, design, and manage unique network configurations within each of these business lines to ensure growth and performance of each network meeting UHC needs. Additionally, market leaders build, attract, and develop a best in class performing network contracting team while working with all other UHC teams. The RVP ensures achievement of key performance metrics, including trend, adequacy, and access, ensuring contracting compliance with regulatory requirements, particularly in the heavily regulated California environment.
Primary Responsibilities: - Develop, design, and manage the medical network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) to yield a geographically competitive network that achieves objectives for unit cost performance and trend management and produces an affordable, predictable product for customers and business partners. As market leader, you will oversee all lines of business to meet the unique expectation of each business lines' needs
- Hire, develop, and retain a high performing contracting team working across company departments to ensure MBOs are met
- Lead the local team while also responsible for ensuring all medical contracts are in compliance with UnitedHealthcare's contract templates and standards, meeting state and federal regulatory requirements
- Establish reimbursement structure standards and other key process controls
- Ensure the network composition includes an appropriate distribution of provider specialties for each line of business and includes multiple narrow network products
- Lead and develop market strategies and visions across multiple lines of business
- Develop, translate, and execute business strategies and objectives for respective markets in the California and Hawaii markets for all lines of business
- Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
- Lead a large multi-state team, setting expectations for strategy development, performance accountability, talent development and succession planning
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 experience
- 10+ years of experience in a network management-related role managing complex network provider systems
- 10+ years of contracting experience in Network / Provider Management
- 8+ years of healthcare experience
- 8+ years of experience in product pricing, financial modeling, and managing a market budget
- 5+ years of supervisory experience
- Experience negotiating capitated, value-based and fee for service arrangements a must
- Proven ability to communicate network strategy and drive results
- Ability to successfully function in a matrix organization
- Ability to successfully leverage relationships both internal and external
- Solid independent decision-making skills to drive sound, quality results in a timely manner
- Solid ability to operate and influence across the enterprise to drive critical decisions and execution
- Demonstrated broad-scope financial expertise
- You will be asked to perform this role in an office setting or other company location
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, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $200,400 to $343,500 annually based on full-time employment. We comply with all minimum wage laws as applicable.
