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Assistant Vice President Medicaid/Medicare Contracting and Payer Relations—Large Integrated Delivery System, Southeast

 

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Job Summary

 

This newly created role will oversee the Government Programs Managed Care Contracting function for one of the nation’s leading and most innovative healthcare organizations.

 

Essential Functions

 

  • Leads a team of Directors/Managers to meet managed care contracting objectives
  • Develops contracting strategy to support the growth of the System for assigned payers, particularly Managed Medicaid and Medicare payers through meeting the critical needs of affiliate facilities as well as supporting operational changes within owned facilities.
  • Ensures appropriate negotiation planning is completed and presented.
  • Ensures assigned team members negotiate assigned contract rates and language within established deadlines with financial results that meets or exceeds net revenue budgets and net margin targets to support the mission of the System.
  • Provides the System with accurate and current managed care market intelligence; maintains a working understanding of local/regional/national trends, conducts competitive market assessments, changes and impact of regulatory environment, changes and impact of payor initiatives and provides other information to support System initiatives.
  • Works with Managed Care Analytics team members to ensure that all required analyses and contract modeling activities are completed in an accurate and timely manner.
  • Oversees the development and delivery of standard contract metrics, reporting frequency, and delivery of Executive Summary report to measure portfolio performance.

 

 

Education, Experience and Certifications

 

Master’s Degree required (MBA or MHA); will consider Bachelor’s Degree with experience in an AVP/VP-level position within a like size or larger organization. Minimum of ten years of experience as a contract negotiator required, preferably Managed Medicare and Medicaid contract negotiations. Combined provider and payor experience as a contract negotiator a plus but must have recent provider side experience.  Proven track record of closing negotiations on time and at or exceeding budget expectations. Closed negotiations for a complex major payor/major system required; experience with multi-entity system and/or large physician multi-specialty group preferred. Risk or value-based contracting experience preferred.

 

Consultant:

For additional information and/or confidential consideration, please contact Tricia French RN, BSN at tfrench@frenchgroup.com

 

The French Group, Healthcare Executive Search

477 Viking Drive, Suite 230

Virginia Beach, VA 23452

(757)362-0202