Vice President, Managed Care Service Area 1
Trinity Health
full-time
Posted on:
Location Type: Hybrid
Location: Livonia • California • Idaho • United States
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Job Level
About the role
- Responsible for payer contracting for the service area consisting of several Regional Health Ministries (RHM) across Illinois, Indiana, Iowa, Idaho, Oregon and California
- Manages negotiation cycle from assessment and identification of value creation opportunities through implementation of the contract
- Negotiates complex and innovative payer contracts
- Coaches team on advanced negotiation methods for APM contracting
- Strives to maintain competitive reimbursement rates for the RHMs within the region
- Oversees delivery of new contracts that leverage alternative reimbursement methodologies such as bundled payment and capitation
- Monitors regional trends by payer and maintains knowledge base by payer
- Provides management oversight of professional and managerial staff within Managed Care
Requirements
- Bachelor’s degree in finance, Accounting, Business Administration, Healthcare Administration, or related area
- 10 years of executive level experience leading Managed Care functions across multiple markets
- Successful past experiences managing complex change initiatives within payer/provider, contracting and network development functions
- Broad based knowledge of healthcare finance, managed care, and health plan contracting
- Demonstrated competency i n advanced contract negotiations
- FHFMA Certification, Fellow of the Healthcare Financial Management Association, and FAHM designation preferred
- Proven knowledge of how to get things done in a complex organization
- Strong analytical skills and effective verbal/written/interpersonal communications skills
Benefits
- Advise RHM senior management, network operations colleagues, and regional Managed Care colleagues on matters related to net revenues.
- Monitors outcomes and focuses resources to maintain the profitability and overall performance of payor relationships.
- Responsible for overall fee schedule pricing including APM.
- Develops goals for RHM contract performance and creates processes that ensure those goals are achieved.
- Provides guidance and coaching as needed to ensure positive contract performance to targets.
- Works in close collaboration with the Payer Strategy & Product Development leadership, Chief Financial Officers and other functional leaders in development and implementation of Managed Care policies.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
payer contractingnegotiation methodsadvanced contract negotiationsalternative reimbursement methodologiesbundled paymentcapitationhealthcare financemanaged carehealth plan contractingchange initiatives
Soft Skills
analytical skillsverbal communicationwritten communicationinterpersonal communicationleadershipcoachingmanagement oversight
Certifications
FHFMA CertificationFAHM designation