Director, Managed Care Negotiations

Adventist Health • Glendale, CA

7h

About The Position

Assumes responsibility for Health Plan (managed care) contracting, payer
in-servicing, contract implementation and contract reporting across the system.
Works in association with the both the corporate and hospital leadership on
contract matters. Serves as liaison between the organizations facilities and
physicians with affiliated health plans, independent practice associations
(IPAs) and other payers. Supervises and directs the activities of various levels
of assigned personnel using both professional and supervisory discretion and
independent judgment.

Requirements

• Bachelor’s Degree or equivalent combination of education/related experience: Required

Nice To Haves

• Master's degree
• Seven years' related experience
• Five years' leadership experience

Responsibilities

• Maintains focus negotiations responsibility for payer relationships including market parity for contract negotiations for Adventist Health hospitals, surgery centers, home health, hospice, long term care facilities, Adventist Health Physician Network, rural health clinics and other Adventist Health affiliated physician organizations.
• Manages, directs, and leads the departmental staff to ensure maximum productivity and efficiency. Plans/monitors/maintains, FTE, capital, and operational budgets. Reviews department systems, concerns, budgets, and goals with leadership, including cost reduction and revenue enhancement.
• Uses comprehensive knowledge of health plan industry with the ability to review and articulate industry financial and claims data points to both external and internal key stakeholders.
• Exercises independent judgment in recruiting, training, coaching, supervising and responsibly directing assigned staff. Directs, organizes, and plans the operation of assigned department at the center and market level.
• Ensures compliance with health plan and payer contracts, and local, state, and federal regulations.
• Performs other job-related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees