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VP- Managed Care-13347-2

Location : Brentwood, TN
Job Type : Direct
Reference Code : Hybrid
Hours : Full Time
Required Years of Experience : 7+
Required Education : Bachelor's Degree in Accounting
Travel : No
Relocation : No
Job Industry : Accounting - Finance
Job Category : Accounting/Finance

Job Description :

Job Summary

The VP Managed Care is responsible for all duties related to managing payor relationships, contract negotiations, financial modeling and tracking of new and existing national and regional payor contract.  Possesses the necessary negotiations skills to establish national-level agreements with Payor Executives.


Duties and Responsibilities:


  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

  • The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Lead, develop and implement strategic relationships with major payors on a regional and/or national level.

  • Support the development and contracting for value-based population health opportunities and new reimbursement models.

  • Identify revenue opportunities with existing and prospective payor agreements.  Maintain contract renewal schedule to ensure timely review and renegotiation of contracts.

  • Manage financial modeling specific to contracting efforts, ensuring negotiated rates meet desired objectives.

  • Provide reports and analysis of performance, providing recommendations and feedback for contract renewals, renegotiations, or termination.

  • Experienced with negotiating national-level contracts with Payor Executives. Possesses an understanding of Payor operations.

  • Responsible for managing a team(s) of negotiators and regional oversight of the strategic development, coordination, and analysis of managed care agreements (Commercial, Medicare, and Medicaid).

  • Responsible for the development and management of the annual contracting budget.

  • Partner with leaders within Revenue Cycle, Business Development, Facilities, Operations, Finance, and Compliance regarding contracting, financial and strategic objectives.

  • Develop reports and reporting solutions specific to payor relations, managed care and contracting needs.

  • Monitor the financial and operational performance and trends of payor contracts and report to Executive Team.

Required Qualifications :

Education/ Experience:

  • Bachelor’s degree in Business Administration, Health Care Administration, or equivalent/related field. (Master’s preferred)

  •  In-depth contracting experience and someone who is very process oriented.

  • 7+ years of related experience negotiating hospital, large physician groups and ancillary services agreements and external customer service for providers.

  •  Experience in marketing/sales/finance in a managed care or insurance environment

  • Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff.

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