POSITION SUMMARY :
This high visibility, enterprise-wide leadership role with LifePoint Health, Inc. is responsible for the organi-zation's overarching managed care strategy and payer relationships. Leading a team of talented man-aged care analytic and negotiating professionals, this position is the primary architect building and shap-ing LifePoint's managed care partnerships, as well as aligning the goals of operational leaders with Life-Point's key payer partners.
ESSENTIAL FUNCTIONS : To perform this job, an individual must perform each essential function satis-factorily with or without a reasonable accommodation.
Collaborate with senior leadership to develop future and execute current MC strategies
Work closely with value-based care and revenue cycle leadership to maximize total reimbursement yield and keep LifePoint assets network essential' to payers
Integrate and align payer strategy with LifePoint's growth and strategic objectives, including value-based contracting strategies, revenue cycle initiatives, consumerism, digital health, service line de-velopment investments, operational process improvement initiatives and M&A activity
Research and monitor insurance industry activities, healthcare reform, and payer strategy to inform managed care, value-based care and revenue cycle priorities
Participate in committees to gain knowledge and influence in state and federal issues
Lead the managed care team in annual budgeting and planning work
Assume leadership role in complex, high-impact negotiations with key payers to ensure financial via-bility and optimized contractual terms
Oversee the Development of monthly financial dashboards for key performance insight
Create clear insight in the form of quarterly reports to summarize managed care negotiating activities at the Division and individual market level
Lead the development of tools shedding light on the performance of key contracts
Work closely with RCM colleagues and health plan contacts to address chronic, trended issues im-peding optimal contract yield
Take leadership role in all aspects of lawsuits, arbitration, mediation and settlements
Ensure managed care team is closely aligned with operations to develop and implement relevant managed care initiatives supporting areas of growth and opportunity
Create a sustainable managed care structure to ensure (a) proper training of new hires, (b) resources for experienced team members and (c) a pipeline of talent for succession planning
Regular and reliable attendance.
Perform other duties as assigned.
Additional Information :
Position serves both internal co-workers and external customers, clients, patients, contractors, and ven-dors.
Access to and / or works with sensitive and / or confidential information.
Exhibit a [comprehensive] understanding of healthcare regulatory and compliance (e.g., HIPAA). Skilled in the application of policies and procedures. Knowledge of Business Office Standards and Recom-mended Practices.
SUPERVISORY RESPONSIBILITIES :
Manage the work of others, including planning, assigning, scheduling and reviewing work, ensures quali-ty standards. Responsible for hiring, terminating, training and developing, reviewing performance and administering corrective action for staff.
KNOWLEDGE, SKILLS & ABILITIES : The requirements listed below are representative of the knowledge, skills and / or abilities required.
Education : Bachelor's degree
Experience : Minimum of 7 years of managed care negotiation and contracting activities experience
Skills and Abilities :
Financial analysis
Contract modeling
Alternative payment methodologies
Key terms and conditions contract language
Negotiation strategy / tactics including escalated payer negotiation disputes
Relevant regulatory and compliance issues
Highly proficient working knowledge of Microsoft operating systems i.e. Word, Excel
Must possess excellent written and oral communication skills
Must be self-motivated and able to meet deadlines
Optimistic, solution-oriented, collaborative by nature
Knows how to cultivate, support and sustain a high-performing team
Possess good organizational skills with high executive function acumen
Lifepoint Health is an Equal Opportunity Employer. Lifepoint Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.
Vice President • Brentwood, TN, United States