Vice President of Managed Care and Network Development

Naphcare, Inc.•Vestavia Hills, AL

25d

About The Position

NaphCare has an excellent opportunity for a Vice President of Managed Care and Network Development to join our Corporate Headquarters in Birmingham, AL. The Vice President of Managed Care and Network Development is responsible for overseeing all national health care contracting activities across NaphCare’s Jail Division, Bureau of Prisons Division, and State Department of Corrections Division. This role provides leadership for provider network development, contract negotiations, reimbursement strategies, and departmental operations for a team of approximately 20 people. NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare.

Requirements

Bachelor’s degree required with Master's/JD Degree preferred.
Minimum of 10 of experience in direct healthcare payor contract negotiations and a minimum of 7 years of operations and staff leadership/oversite.
Strong knowledge of Medicare reimbursement methodology including prospective payment systems and Part B.
Sound technology/software systems experience with good data analytic skill sets, ability to automate processes with technology, and advanced excel capabilities.
Ability to lead multiple teams, manage multiple lines of business, and execute complex projects concurrently
Strong communication and collaborative leadership skills.
Ability to motivate, mentor, and develop staff.
Strategic thinker with strong execution and organizational skills.
Must have the ability to stand for long periods, lift and move patients (up to 50 pounds), bend, squat, reach, push, pull, walk significant distances, and perform physically demanding tasks like CPR, all while maintaining good balance and endurance throughout a shift.

Nice To Haves

Master's/JD Degree preferred.

Responsibilities

Lead the team in evaluating, negotiating, and securing financially and administratively favorable contracts with new and existing community providers (hospitals and physician groups)
Develop and support managed care strategies and initiatives to adapt to ongoing healthcare payment reforms and Medicare and Medicaid payment methodologies.
Develop and foster effective collaboration between clinical departments, divisions, medical staff leadership, and other affiliated services to ensure an integrated approach to providing services and fulfilling the organization's goals.
Oversee network development staff in the development of provider networks across all existing correctional contracts.
Oversee new network development for new RFP responses.
Perform periodic analyses of the provider network from a cost, coverage, and growth perspective.
Manage budgeting and forecasting initiatives for product lines to network costs and provider contracts.
Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
Ability to travel 10%.