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Job: Director, Managed Care

This posting has expired and is no longer available.

Job Description

POSITION SUMMARY: 
Under the direct supervision of the VP of Managed Care, the Director, Managed Care serves the market(s) to assure the accurate implementation and administration of managed care contracts, processes, procedures, and hospital/corporate managed care growth initiatives.
PRIMARY RESPONSIBILITIES: 
  • Renegotiation of hospital and/or physician managed care agreements in accordance with the Contracting Plan developed each fiscal year.
  • Interface with payors on contract compliance issues-this position will work closely with the business offices, case management and the CFOs to resolve disputes with the payors. Ensure that A/R days and denials (both admin and clinical) are minimized.
  • Annual managed care market planning process on a macro and micro basis
  • On-going monitoring of financial performance of the managed care agreements
  • Assists in the negotiation and renegotiation of managed care and/or other third party payor contracts to achieve operation objectives with results that are in accord with overall market needs and budgeted targets.
  • Carries out appropriate managed care related education and training, including the roll out and implementation of new payor contracts; and assures that new contracts are implemented in a timely and accurate manner.
  • Participates in weekly, regional revenue cycle teleconference to address existing reimbursement related issues, including but not limited to claim denials, underpayments, and bad debt.
  • Support of hospital and corporate strategies.


Qualifications

SKILL OR EXPERIENCE REQUIREMENTS:
  • Minimum seven (7) to ten (10) years’ experience
  • Experience with payor and/or provider
  • Ability to manage multiple markets/hospitals/negotiations
  • Strong negotiation skills
 
EDUCATION OR SPECIFIC TRAINING REQUIREMENTS:
  • Bachelor’s degree in business, hospital management, or a related field is required.
  • Master’s degree in business, marketing, or hospital management is preferred.
 
ADDITIONAL SKILLS NEEDED:
*            High degree of understanding of hospital financing/reimbursement
*            Communication skills, both oral and written
*            Ability to build and maintain relationships
*            Excel skills
 
ADDITIONAL COMMENTS:
*            25-50% travel required.

Equal Opportunity Employer Minorities/Women/Veterans/Disabled

 
IASIS Healthcare | 117 Seaboard Lane, Building E, Franklin, TN 37067 | p) 615-844-2747 | f) 615-846-3006
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