Conducts complex negotiations on all contractual provisions of major national managed care payers for facilities, ancillary & professional services of integrated delivery system and clinically integrated network. Implements strategic initiatives to achieve organizations and departments goals.
1. Conducts complex language and financial analysis with major national payors. Deploys contract strategy for hospitals, ancillaries, physician and other professional services. Implements legal, financial & business requirements & objectives through negotiations.
2. Initiates the managed care plan, operations, obligations & responsibilities inter-departmentally throughout Memorial Healthcare System. Communicates and resolves issues.
3. Seeks and initiates new business opportunities (relationships, pricing, services, structures, operations, quality). Implement strategies and operations to protect and build market share.
4. Directs department operations, activities, resources to meet budget and goals.
5. Plans and monitors activities and staff including hiring, orienting, training, mentoring, continuing education, evaluating, coaching & disciplinary actions of supervised staff members.
Education: Bachelor’s degree in related field.
Licensure, Certification and Registration: None required.
Complexity of Work: Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Strong technical, financial and negotiation skills. Extensive managed care insurance and hospital industry knowledge.
Required Work Experience: 7 years managed care contracting experience with emphasis on facility contracting.
Memorial Healthcare System, consisting of 6 acute care hospitals, a nursing home, outpatient facilities, home health services and physician practices, provides quality, comprehensive care to the residents of the surrounding communities. We invite you to join one of the nation’s leading healthcare systems, recognized for use of advanced technology and clinical informatics.
Memorial Support Services provides a variety of business services to support our facilities. The main offices are located in Miramar with satellite offices located throughout our system.
Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.
Employment at Memorial Healthcare System is subject to post offer, pre-placement assessment, including drug testing.