Vice President, Provider Relations and Contracting
Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
ABOUT UCAREAt UCare, we deliver high-quality health coverage and services to help members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities. WORKING AT UCAREWorking at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other. Our values of integrity, community, quality, flexibility, and respect permeate every aspect of our organization - from who we are and how we act, to what we do and how we do it. We owe our continued success to our employees who proudly embody our mission and values in everything they do. VICE PRESIDENT, PROVIDER RELATIONS AND CONTRACTING Position DescriptionThis position is responsible for the short and long term strategic direction of the Provider Relations and Contraction Department. This position is responsible for: (a) developing, maintaining and strengthening UCare's provider relationships to achieve strategic growth, financial goals and high-quality, cost-effective care and services for their members; (b) ensuring networks are contracted and implemented to support product and financial performance; and (c) work closely with other business leaders on key strategic initiatives including developing value-based and innovative arrangements with providers. In addition, this position will work with internal operational leaders to meet data reporting and analysis needs, and to ensure a positive provider experience. Specific duties and responsibilities include: Duties and responsibilities listed below are essential function of the position.Create and maintain a comprehensive provider relations, contracting and network management strategy that meets the needs of the existing membership and supports projected growth and new product development. Develop strong relationships with key internal and external constituents with the goal of communicating UCare's value proposition and continued revenue expansion to support UCare's growth strategy. Lead in collaboration with operational leaders in the development and maintenance of processes that ensure a positive provider experience, including timely communication, identifying and addressing issue root causes, obtaining actionable provider input, and providing prompt and accurate resolution of issues. In coordination with the SVP, Chief Marketing Officer, collaborate with product management and business development leaders in the creation of new products, enhancement of current products, and strategic alliances with provider systems. Establish in cooperation with financial leaders provider reimbursement strategies that support the financial objectives of the organization while meeting network access goals defined by the business. Develop and help negotiate value-based arrangements with provider systems, which support competitive products and quality health outcomes.Develop and implement with clinical and financial leaders network contracting strategies designed to achieve appropriate utilization, accurate risk adjustment revenue, and targeted quality outcomes such as Medicare Stars measures. Ensure the development and maintenance of effective and efficient department operations as well as contract implementation and tracking processes through ongoing process improvement efforts. This includes ensuring documents are signed, processed and implemented timely and accurately and defined contract implementation timelines are met and effective communication with internal departments and external parties are deployed. Develop and maintain processes and tools that collect, maintain and report timely and accurate provider data to address business and compliance goals. Maintain provider on-boarding that supports the efficient and effective addition of new providers that satisfy network and credentialing standards, and ensure their ongoing provider network eligibility. Collaborate with clinical and credentialing leaders in any credentialing actions. Ensure an effective provider communications plan that educates providers through multiple distribution channels about critical contracting and business issues. Participate in the development of strategic marketing approaches with the provider community. Monitor all provider business relationships to ensure they meet contractual requirements including the creation of any unique servicing arrangements. Establish appropriate oversight and auditing of any delegated activities. Coach, mentor, and manage a high-performing team of professionals to ensure positive both short and long term strategic goals are achieved. Develop an annual budget and perform within those limits. EducationBachelor's degree in health care management, business administration or related field required. Masters preferred. Required ExperienceTen (10) years experience in a health care delivery setting, such as a physician group practice, health insurance company, managed care organization or community service agency required. Seven (7) years experience in a leadership role. Preferred ExperienceSignificant previous experience developing contracts and reimbursement strategies for statewide provider networks specifically for government program business.THE UCARE DIFFERENCEUCare is proud to be a recognized Star Tribune Top Workplace for the 8th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply. As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.