Vice President Managed Care and Contracting

Hospital for Special Surgery•New York, NY

21h

About The Position

How you move is why we’re here. ® Now more than ever. Get back to what you need and love to do. The possibilities are endless... Now more than ever, our guiding principles are helping us in our search for exceptional talent - candidates who align with our unique workplace culture and who want to maximize the abundant opportunities for growth and success. If this describes you then let’s talk! HSS is consistently among the top-ranked hospitals for orthopedics and rheumatology by U.S. News & World Report. As a recipient of the Magnet Award for Nursing Excellence, HSS was the first hospital in New York City to receive the distinguished designation. Whether you are early in your career or an expert in your field, you will find HSS an innovative, supportive and inclusive environment. Working with colleagues who love what they do and are deeply committed to our Mission, you too can be part of our transformation across the enterprise.

Requirements

Strong leadership and communication skills
Proven track record of managing relationships well, both internally and externally
Comfortable working in a collaborative and consensus building environment
Ability to work with a variety of constituents (CEOs, CFOs, and senior managed care executives)
Subject matter expert for relevant stakeholders on all matters of health care reimbursement and medical cost improvement
Experience in developing strategy and executing new market expansion
Experience in management of payer joint venture relationships
Experience chairing Joint Operating Committees with Payers to ensure revenue is collected timely
Experience in developing and implementing a creative payer strategy
Experience in effective negotiation and maintenance of assigned payer contracts
Experience as a leader of an Account Management team
Ability to ensure smooth contract operations to include issue resolution and contract compliance
Ability to develop strong relationships based on trust across the senior leadership team, physician community and payers
Ability to drive measurable improvements to the cost of health care while ensuring excellent patient outcomes via performance metrics and value-based incentives
Ability to enable higher performance by incrementally improving data and analytics approaches based on calculated risks and benefits
Ability to proactively seek to improve processes and implement best-in-class solutions, raising quality and productivity in a calculated way
Ability to identify new processes and/or systems to improve productivity and/or make the organization more efficient
Ability to benchmark his/her own performance against industry best practices
Strategic thinking: Thinks about the business from a long-term perspective, considering how trends in healthcare will impact HSS and its various stakeholders. Formulates hypothesis or alternative scenarios for how critical issues, like the shift to value based care, will play out beyond the year, and uses those to set challenging goals with future payoff or outcome.

Responsibilities

Collaboratively working with the SVP of Managed Care and Contracting, the VP is responsible for the global contracting strategy and reimbursement models for payers that are offered to large employers, insurance companies, Medicare and Medicaid beneficiaries.
Display strong leadership and communication skills and possess a proven track record of managing relationships well, both internally and externally. The successful candidate will be comfortable working in a collaborative and consensus building environment and can work with a variety of constituents (CEOs, CFOs, and senior managed care executives).
Serve as an educator and facilitator, both internally and externally, to ensure HSS is positioned strongly to maximize its status as the world’s premier musculoskeletal health organization.
Develop alternative reimbursement arrangements with Employers and Payers in order to manage musculoskeletal medical costs more effectively across populations.
Acts as SME for relevant stakeholders on all matters of health care reimbursement and medical cost improvement.
Develop strategy and execute new market expansion.
Management of payer joint venture relationships.
Chair the Joint Operating Committees with Payers to ensure revenue is collected timely.
Development and implementation of a creative payer strategy that positions HSS for success in a rapidly evolving reimbursement environment.
Effective negotiation and maintenance of assigned payer contracts.
As the leader of the Account Management team, ensure smooth contract operations to include issue resolution and contract compliance.
Develop strong relationships based on trust across the senior leadership team, physician community and payers.
Drive measurable improvements to the cost of health care while ensuring excellent patient outcomes via performance metrics and value-based incentives.
Enable higher performance by incrementally improving data and analytics approaches based on calculated risks and benefits.
Proactively seek to improve processes and implement best-in-class solutions, raising quality and productivity in a calculated way.
Identify new processes and/or systems to improve productivity and/or make the organization more efficient.
Benchmark his/her own performance against industry best practices.
Thinks about the business from a long-term perspective, considering how trends in healthcare will impact HSS and its various stakeholders. Formulates hypothesis or alternative scenarios for how critical issues, like the shift to value based care, will play out beyond the year, and uses those to set challenging goals with future payoff or outcome.