The HealthCare Initiative
Where Talent Meets Opportunity
The Healthcare Initiative
Director Managed Care
Is the phrase “We going in a different direction” (translation: “we don’t value you anymore”) the current song of the day in your organization? Or does COVID have you rethinking if you are still in the right organization?
Well, consider bringing your talent and expertise to one of the strongest regional community hospital systems in the south where employee contribution and loyalty are valued. Enjoy a strong quality of life with a significant professional body of work where healthcare is truly integrated with the community. Truly one of America’s most livable communities and regarded health system!
In this role, you will be a valued part of the overall health system team responsible for overseeing the planning, implementation, monitoring and effective utilization of managed care alternative payment model contracts for a financially stable growing health system. Bring your expertise in value based contracting, Medicare Advantage/Medicaid plans, and strong experience working with commercial payers.
- Develop plan and implement strategies for payer engagement, contract management and negotiations.
- Assess and make recommendations to improve efficiency of current process for contract development and implementation
- Keep abreast and disseminate pertinent regulatory and insurance related information in order t promote timely and efficient billing of all inpatient, outpatient, and ancillary services
- Build and maintain relationships with key Third Party stakeholders to enable strong negotiating results and optimal payer revenue growth
- Negotiate contract agreements/reimbursement rates
- Provide proactive and responsive communication to payers, senior leadership and administrators
- Analyze and review monthly results for risk against annual plan and forecast projections, providing variance explanations/recommendations
- Provide financial support in the completion of monthly system reporting
- Provide servant leadership to team of dedicated professionals to contribute to the continued success and growth of the function and organization and provide mentoring for career development.
- BS Accounting, Administration or Hospitalization
- Masters or CPA preferred
- 5 years experience in negotiating payer contracts within a health system or hospital, experience on the payer side a plus.
- Exceptional interpersonal skills for communications, collaboration, relationship building with internal and external stakeholder
- Strong negotiation and analytical skills
- Digitally savvy and proficiency with computer hardware/software programs in managed care arena
This search is being led by Sue Forster, Managing Partner at The Healthcare Initiative.
Please contact Sue.Forster@thehealthcareinitiative.com for expressing your interest in learning more or sharing referrals in confidence.
Experience: Director Management (Director/Head of Organization)
Education: Bachelor’s Degree
Industry: Healthcare / Healthcare Services