Hybrid Vice President, Managed Care Service Area 1

at Trinity Health

• Job title: Vice President, Managed Care Service Area 1
• Job type: Full Time
• Experience level: Lead
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Livonia, United States

About the role

• Vice President of Managed Care develops strategies for payer contracting. Overseeing contract negotiations and providing leadership for Regional Health Ministries across multiple states.

Responsibilities

• Responsible for payer contracting for the service area consisting of several Regional Health Ministries (RHM) across Illinois, Indiana, Iowa, Idaho, Oregon and California
• Manages negotiation cycle from assessment and identification of value creation opportunities through implementation of the contract
• Negotiates complex and innovative payer contracts
• Coaches team on advanced negotiation methods for APM contracting
• Strives to maintain competitive reimbursement rates for the RHMs within the region
• Oversees delivery of new contracts that leverage alternative reimbursement methodologies such as bundled payment and capitation
• Monitors regional trends by payer and maintains knowledge base by payer
• Provides management oversight of professional and managerial staff within Managed Care

Requirements

• Bachelor’s degree in finance, Accounting, Business Administration, Healthcare Administration, or related area
• 10 years of executive level experience leading Managed Care functions across multiple markets
• Successful past experiences managing complex change initiatives within payer/provider, contracting and network development functions
• Broad based knowledge of healthcare finance, managed care, and health plan contracting
• Demonstrated competency i n advanced contract negotiations
• FHFMA Certification, Fellow of the Healthcare Financial Management Association, and FAHM designation preferred
• Proven knowledge of how to get things done in a complex organization
• Strong analytical skills and effective verbal/written/interpersonal communications skills

Benefits

• Advise RHM senior management, network operations colleagues, and regional Managed Care colleagues on matters related to net revenues.
• Monitors outcomes and focuses resources to maintain the profitability and overall performance of payor relationships.
• Responsible for overall fee schedule pricing including APM.
• Develops goals for RHM contract performance and creates processes that ensure those goals are achieved.
• Provides guidance and coaching as needed to ensure positive contract performance to targets.
• Works in close collaboration with the Payer Strategy & Product Development leadership, Chief Financial Officers and other functional leaders in development and implementation of Managed Care policies.