We're looking for a candidate to fill this position in an
Forge and enhance strategic partnerships and continuum
relationships to improve quality of care and continuum
Align and integrate clinical, programmatic, quality, and
Develop and implement robust business, contractual rates
(Managed Care, ACO, VBP), and census growth plans
Advance and elevate clinical, cultural, and operational outcomes
through development and facilitation of transitional care,
readmission reduction, and continuum-based initiatives
Engage in complex levels of contract development and
negotiation, including risk agreements using utilization, claims
and market data with health plans and direct service agreements
with physicians, physician organizations and hospitals and
Execute and operationalize ACO, Bundled Payment, Alternative
payment, narrow network, and innovative reimbursement models in
collaboration with Facility leadership
Manage complex and high-profile health plan negotiations.
Actively draft and negotiate contracts in the health care
operations and health care plan functional areas
Teach, train and instruct facility level personnel on growth and
Work collaboratively with the PACC and Managed Care Resource
Executive-level Healthcare leadership and management experience
required (Acute, Post-Acute, Physician/Provider Group, Payer,
Knowledge of managed care contracting language, requirements,
and methods to support the development and maintenance of contract
compliance, contract language review and contract analysis.
Must be knowledgeable about the managed care environment;
including Alternative payment models, Value-Based Initiatives and
programs, capitation as well as experience with lines of business
including Medicare Advantage, Commercial, Managed Medicaid and Dual
Knowledge of CPT-4, HCPCS, Revenue and ICD coding.
Expert in Alternative Payment Models, Value-Based Initiatives
and Programs, etc.
Ability to be flexible, be readily adaptable, and work in a
rapidly and constantly changing environment.
Microsoft Excel and Data Analytic expertise
Willing to travel up to 30% of the time; including WA and NV