Director, Managed Care Contracting

About the position

We’re hunting for a Director of Managed Care Contracting, someone who’s ready to be part of the best ranked children’s hospital in Texas, and among the best in the nation. In this position, you will develop and maintain all third-party payer contracts for Integrated Delivery System (IDS), including but not limited to Hospital and Physician Service Organization (PSO), Pediatrics, Urgent Care, and Children's Specialty Pharmacy.

Responsibilities

• Plan, develop, organize, direct and implement a coordinated approach to contracting which assures that the obligations of contractual agreements with HHSC, TDI and legislative regulations as it pertains to contracting for hospitals, physicians and other healthcare providers.
• Provide development and supervision of managers and staff.
• Participate in interdepartmental groups to represent managed care contracting needs including claims, medical management, operations, finance, quality improvement and other related services.
• Maintain adequate levels of qualified and competent staff in the department by collaborating with the leadership team in the recruitment and hiring of departmental employees.
• Facilitate orientation of staff to the department and provide appropriate feedback and evaluation of progress.
• Establish goals for performance standards.
• Provide for training and development of staff to achieve standards and meet or exceed industry benchmarks for operations and performance.
• Provide oversight and analysis of managed care contracting services, evaluation of program offerings, health trends, and pricing strategies.
• Develop approaches, policies and programs for contracting strategies which are based on the goals and objectives, and which meet the performance goals.
• Support the delivery of cost effective, community-based and culturally sensitive health care through development of educational and collaboration opportunities with payers.

Requirements

• Bachelor's Degree required
• 7 years healthcare experience, including 3 years of managed care experience in a managed care organization and including 2 years of supervisory experience required