Director Managed Care Contracting | The Confidential Search Company

13 Jun 2018 12:48 PM | Anonymous

Position Description: The Confidential Search Company is an executive recruitment firm with over twenty-five years of experience placing healthcare financial and administrative executives, director, managers and specialists. We have been engaged to conduct an executive search for a Director Managed Care Contracting for our client, a 300+ bed full service health care facility with $300m in net revenue, multiple clinic sites, and high volume outpatient service (including a $30m physician practice association) and enjoys a national reputation, located in southern New Hampshire. The starting salary is up to $120k. Relocation assistance will be available as appropriate.

The Director of Managed Care Contracting will:

      Managed Care

  • Develop and implement a managed care strategy for the Medical Center and its subsidiaries
  • Represent the Medical Center and its subsidiaries in all managed care contract negotiations
  • Responsible for ensuring entities at all levels of the organization will be informed about any and all terms of negotiated contracts and understand their role in ensuring contracts are implemented quickly and correctly
  • Responsible for managing the organization’s performance on it’s risk-based contracts, involving key staff and physicians as necessary
  • Represent the organization at all payor meetings to discuss medical management and budget outcomes
  • Seek and obtain additional managed care contracts as a result of establishing contacts and developing professional relationships with existing and potential payors
  • Identify, analyze and develop potential joint marketing strategies with managed care payors and other providers for the benefit of the Medical Center


      Accountable Care

  • Assess the readiness of the organization and related set of providers (primary care physicians, specialists and the hospital) that can be held accountable for the cost and quality of care delivered to a defined population
  • Assist the Executive Director of Population Health to determine optimum means to deliver coordinated and efficient care for the defined population while achieving quality and cost targets including:
  1. Care for patients across the continuum of care
  2. Plan prospectively for its’ budget and resource needs
  3. Support comprehensive, valid and reliable measurement of its’ performance
  • Assist in discussion and plans to assess the following:
  1. How the ACO will be structured
  2. What Provide payment methodology best fits the needs of the organization
  3. How quality will be assessed
  4. Define population that best fits the organization

Qualifications

  • Bachelor’s degree in healthcare or related field required
  • MBA or MHA preferred
  • Minimum of five years managed care experience in contract negotiation, sales/marketing, provider relations, and/or business development with at least three at a management level
  • Familiarity with regional HMO/PPO market is essential
  • At least two years experience in a capitated environment within an integrated delivery system or HMO is required
  • Demonstrated project management skills

All inquiries will be treated confidentially.

Interested candidates should send their resume and salary history to:

Matthew O’Brien
The Confidential Search Company
ConfSearch@aol.com
860-742-1555

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