Director, Managed Care, Integrated Market
Location: Louisville Kentucky
Description: Kindred Healthcare is employing Director, Managed Care, Integrated Market right now, this job will be placed in Kentucky. More complete informations about this job opportunity kindly see the descriptions. (
Job Number:
137765
)
Description
We are recruiting a Director, Managed Care, Integrated Market to join our Managed Care Ope! rations in the Greater Boston, MA market.
PLEASE NOTE: This position requires residency in the defined market area.
Kindred is looking for an experienced Managed Care executive to lead development and execution of the Managed Care strategy, including all managed care related contracting and payer relations initiatives for the Massachusetts Region (which includes Greater Boston, Northern NE and Southern NE). This individual will serve as a key market leader and critical liaison between the market’s managed care payers and Kindred operations (Hospital Division, Nursing Center Division, Homecare, Hospice, etc.) and support services (Case Management, Sales and Marketing, Business Office, etc.). Collaborates with market colleagues to identify new business opportunities and systematic clinical or operational issues with managed care payers, revenue enhancement opportunities through improved Managed Care contracting, including alternative payment models,! as necessary.
Directly supervises two (2) Director o! f Managed Care Relationship (DOMCR) positions, which are both internal and external facing, as they establish, manage and enhance effective working relationships with managed care payers. Executes on business development opportunities by focusing on Kindred’s value proposition and drives increased managed care penetration across the Kindred’s full post-acute continuum of care.
Essential Functions:
Develops and updates the local Market Managed Care Strategy, in collaboration with Operations leadership, the DOMCRs and other market colleagues.
In collaboration with the regional Senior Director of Managed Care, determines the optimal allocation of necessary resources to effectively manage the relationships with payers in the market, including provider organizations under a contractual or risk-bearing agreement
Coordinates efforts among DOMCRs as they build and maintain managed care payer relationships in support of the Managed Care stra! tegy for each market to ensure:
Appropriate contact and communication at all necessary levels within the payer organization (e.g. contracting, medical management, discharge planning, etc.)
Communication of the continuum of care value proposition
Resolution of “barriers to entryâ€
Consistency of messaging in general
Owns and manages all aspects of assigned portfolio of managed care contracts and associated payer relationships, including:
Identifying opportunities to grow our Managed Care business and scheduling meetings with the relevant payer contacts
Creating tailored presentations / materials
Seeking preparation and attendance support from appropriate internal colleagues, as necessary
Leading payer meetings
Supports DOMCRs in sponsoring quarterly Joint Operating Committee (JOC) meetings with managed care payer leadership and key decision-makers to identify and pursue business grow! th opportunities, resolve key clinical and/or operational issues, etc. !
Sponsors quarterly cross-divisional, cross-functional Managed Care Meetings (a forum for communication between the market’s key internal constituents) to assess key managed care trends, inform and adjust market-based managed care strategies and contract initiatives.
Ensures DOMCRs are appropriately trained / trains core group of market operators on relevant elements of new or renegotiated contracts.
Updates payer-specific activity for assigned accounts including contract development and implementation.
Documents critical reporting capabilities for Kindred based on payers’ evolving data needs, as identified in JOC and other meetings.
Direct Contract Responsibilities:
Works collaboratively with key internal constituents (e.g. Operations leadership, CFOs, other managed care team members, etc.) to establish optimal Managed Care pricing.
Leads the financial analysis of various pricing methodologies and scenario! s.
Directly negotiates contracts with acceptable managed care payers than enable assigned markets to meet their performance objectives.
Maintain integrity of managed care information, including Managed Care Databases, contract rate dissemination and education in concert with Sr Dir Managed Care.
Monitors and keeps current on Federal/State laws and regulations as they apply to health benefit contracts.
Tracks and monitors all contract activity for assigned market area.
Builds consensus with Market Executive Directors/CFO and Sr Dir Managed Care on Managed Care goals, objectives, strategies, individual contract terms, etc.
Prepares financial impact analysis/ modeling on new and revised contracts and maintains oversight tracking and yield determination.
Qualifications
Bachelor's degree in business or related field. Master's degree preferred.
10+ years healthcare experience in the areas of managed ! care contracting and/or business development. Knowledge of the Post-Acu! te industry preferred.
Self-motivated and results oriented.
Strong organizational and interpersonal skills, including the ability to work collaboratively in a matrix environment with colleagues at all levels of the organization to achieve defined market-specific goals.
Ability to apply knowledge of clinical coding/terminology and various reimbursement methodologies, including regulatory requirements to acceptable managed care contract terms.
Comprehensive understanding of industry standard managed contract language.
Ability to effectively communicate in English in verbal, written, and presentation form.
Demonstrated analytical abilities and proficient planning and negotiation skills.
Ability to travel occasionally; estimated at 30%.
Job
:
Business Planning/Development
Primary Location
:
KY-Louisville-Kindred Healthcare
Shift
:
Day
If you were eligible to this job, please email us your resume, with salary requirements and a resume to Kindred Healthcare.
If you interested on this job just click on the Apply button, you will be redirected to the official website
This job starts available on: Sun, 28 Jul 2013 10:36:34 GMT
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