Regional VP, Professional Network Relations - Rockville, MD

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.



Spectera UnitedHealthcare Dental, a UnitedHealth Group Company, is a billion dollar Baltimore based pioneer and industry leader in providing vision and and dental health benefits across the country.  Still growing strong with over 1,200 employees, we offer professional and rewarding opportunities in a company that makes a difference in peoples lives.  Spectera Unitedhealthcare Dental is a member of the UnitedHealth Group family of companies, a Fortune 40 provider of health and well being services to people in all stages of life. 

 

The Regional Vice President, Professional Relations, is responsible for the strategic and tactical implementation of all activities related to maintaining the health plan's dental and vision provider delivery system for the Eastern and Central US regions. This includes ensuring that the delivery system is cost effective, marketable, stable and offers broad access through long-term, mutually successful dental and vision ancillary provider relationships.
Promote and maintain professional relationships with participating providers, and evaluate and analyze effectiveness and efficiency of the provider network.
Conduct contract and fee negotiations with existing providers in conjunction with senior management, monitor contract compliance by the organization and its providers, and assist with credentialing and re-credentialing activities.
Provides direction to a minimum of two management/exempt level positions.Leads, motivates, develops and coaches provider relations staff to achieve high standards of service and performance excellence. 


S/he will also initiate problem solving activities in response to member, staff, or provider complaints, and billing or payment discrepancies.


Lead the implementation of process improvements within the department and cross functionally as applicable.  Establish and manage appropriate performance metrics and reporting requirements. 


Implements programs to develop and maintain positive relationships between plan dental and vision providers and practice managers as well as with professional organizations and societies.


Implements programs to influence and change behavior of dental and vision providers in accordance with plan goals and objectives.


Provide advice/guidance/recommendations to senior management regarding best practices, provider performance issues and provider network service levels.


Maintain highest personal/professional integrity and enforce Principals of Integrity an Compliance.


Strong strategic and business acumen and well grounded in health care delivery systems.
Demonstrates capability to get results in a complex, often ambiguous environment.
Takes and manages risks.
Builds and leverages a network of experts to supplement one own's expertise.
Establishes trust and credibility at all levels of the organization.
Capable of managing a variety of complex issues while driving momentum of key projects.
Creates and conveys a strategic vision.
Translates strategic initiatives into tactical actions.
Ability to build strong relationships with within and outside of UHC.
Identifies leaders and develops staff.
Demonstrates expert negotiation skills.
Actively listens to understand the perspective of others - seeks first to understand.
Openly and actively communicates information and takes initiative to communicate extensively.
Handles difficult situations diplomatically.
Confronts issues directly and speaks candidly.
Effective interpersonal influence, collaboration and listening skills. Promotes recognition of others.
Holds herself/himself mutually accountable with their team.
Models and supports effective team interactions.
Realizes the performance potential of teams.
Encourages diverse opinions and expression of constructive disagreement. Seeks opportunities for team play.
BS / BA degree in business, health care administration or related field, MBA or MPH preferred. DDS/DMD encouraged but not required.
8 to 10 years of progressively more responsible health care administration experience with strong preference for managed care experience.
A minimum of four years experience in a leadership role.
Demonstrates broad-scope financial expertise.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V