Director, Managed Care

Salary Range: $196,000.00 - $294,000.00
Washington Hospital Healthcare System Job Description
Job Code: 714
The Director, Managed Care Contracting, contributes to WHHS’ growth
Job Title: Director, Managed Care Contracting
Position Summary
The Director, Managed Care Contracting, contributes to WHHS’ growth and profitability by providing contracting expertise to existing and new contractual relationships; and providing subject matter expertise, guidance, and direction regarding Managed Care Contracts. This includes coordination of commercial, Medicare Advantage, Medi-Cal Managed Care, Value-Based, Medicare Shared Savings, and other third party managed care contracts and Payor relation activities for Washington Hospital, Washington Township Medical Foundation, and DEVCO entities (surgery centers and other ancillary entities). The Director will be responsible for overseeing administration, review, and financial analyses of managed care contracts for the healthcare system, performing financial reporting and financial modeling for senior management strategic managed care decision­ making, and overseeing all Payor relations and managed care denial follow-up and resolution activities for the health care system. In addition to performing the essential functions listed below, may also be assigned other duties as required.
Statement of Accountability:
Reports to: Vice President & Chief Revenue Officer
Qualifications
Education:
Required: Bachelor's degree (minimum ten 10 years’ experience can be substituted for formal education).
Desirable: Master's degree in health related field
Experience:
- Minimum seven (7) years in a Managed Care Contracting capacity within a health plan or hospital; and at least the five (5) years of experience managing and mentoring Contract Manager or Payor Relations representatives.
- Experience in an administratively responsible position with significant intra-department work.
- Demonstrated interpersonal skills.
- Demonstrated skill in working with a large variety of people of various organizations and levels.
- Knowledge of legal terminology, understanding of governmental and legislative regulations.
- Previous experience in the areas of managed care/finance/or patient