Senior Director, Regional Managed Care
Posted on Mar 11, 2019 by Ascension
We Are Hiring
Senior Director, Regional Managed Care - Managed Care Contracting - Seton Healthcare Family - Austin, TX
Why Join Ascension?
Ascension is a faith-based healthcare organization dedicated to transformation through innovation across the continuum of care. As the largest non-profit health system in the U.S. and the world's largest Catholic health system, Ascension is committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. In FY2017, Ascension provided more than $1.8 billion in care of persons living in poverty and other community benefit programs. Ascension includes approximately 165,000 associates and 34,000 aligned providers. Ascension's Healthcare Division operates more than 2,600 sites of care - including 153 hospitals and more than 50 senior living facilities - in 22 states and the District of Columbia, while its Solutions Division provides a variety of services and solutions including physician practice management, venture capital investing, investment management, biomedical engineering, facilities management, clinical care management, information services, risk management, and contracting through Ascension's own group purchasing organization.
What You Will Do
As the Senior Director, Regional Managed Care, you will have the opportunity to direct managed care activities and resources.
- Managed care contracted revenue under the Regional Managed Care Lead's responsibility approximates $3 to $5 billion.
- Core market responsibilities in Texas with additional markets assigned (i.e. Kansas, Oklahoma)
- Develops and implements strategic and operational goals and objectives.
- Ensures policies and procedures are current and in compliance applicable regulations and standards.
- Makes recommendations based on changes and trends in the area of managed care, reimbursement and applicable state and federal regulatory environment.
- Provides mechanisms to solicit feedback on payer performance, departmental needs and satisfaction with payor services in designated areas of responsibility.
- Ensures problems, complaints and deficiencies with payors are investigated and appropriate actions taken.
- Develops and evaluates departmental and payor benchmark key performance indicators and major processes.
- Oversees the development, negotiation, implementation, monitoring and management of all managed care agreements within the assigned markets.
- Oversees managed care strategy and contracting across multiple ministry markets.
- Responsible in leading and negotiating complex regional contracts and oversees local ministry contracting performance.
- Responsible for centralized functions, such as value-based contracting, revenue cycle alignment and contract pricing/analytics as may be assigned by the Vice President.
- Analyzes and interprets system-wide analytical information and provides system and local level leadership with insightful observations and action plans to address trends.
What You Will Need
- Bachelor Level Degree required.
- Master's degree in business, public health or healthcare is preferred.
- Eight years demonstrated experience and success in contract negotiation and managed care is required.
Equal Employment Opportunity
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