Post Acute Continuum of Care Director

Company: Ensign Services
Location: Redmond
Posted on: September 12, 2020

Job Description:

We're looking for a candidate to fill this position in an exciting company.

Forge and enhance strategic partnerships and continuum relationships to improve quality of care and continuum collaboration

Align and integrate clinical, programmatic, quality, and value-based initiatives

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 ancillary providers

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 alignment initiatives

Work collaboratively with the PACC and Managed Care Resource Teams

Executive-level Healthcare leadership and management experience required (Acute, Post-Acute, Physician/Provider Group, Payer, etc.)

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 programs

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

Keywords: Ensign Services, Redmond , Post Acute Continuum of Care Director, Other , Redmond, Washington