Exec. Director Contracting & Managed Care
Apply NowCompany: CHOC - Children's Health Orange County
Location: Orange, CA 92867
Description:
Work Location
Orange, California
Work Shift
Day - 08hrs (United States of America)
Why CHOC?
At CHOC, we strive to be the leading destination of children's health by providing exceptional and innovative care. We are responsible for the overall health of our community's pediatric population in our hospitals, clinics, and practices. And because of our breadth of care, your career at CHOC can be as diverse and fulfilling as you determine. CHOC's compensation structure, benefits offerings, and career development programs are geared to helping you achieve your professional and personal goals. Apply now to see where your career at CHOC can take you.
Job Summary
The Executive Director, Contracting & Managed Care develops, recommends and actively participates in specific contract strategy(s) or negotiations for new and renewing payer agreements for a multi-hospital and medical foundation system; initiate contract performance review, analysis and implementation of managed care contract negotiations, organize and lead interdepartmental teams in operationalizing managed care contracts and resolve identified managed care operational issues; participates in the development of contract management information systems. Supports the development and evaluation of new business relationships with physicians, medical groups and payers in order to increase service line volumes, overall commercial contract performance and market share. Provider network development and contracting to support at-risk products.
Pay Range
Minimum $203,507 Midpoint $269,630 Maximum $335,795
Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.
Experience
Required: Minimum ten years of experience in contracts and managed care in both hospital as well as heath plan or physician components under Fee for Service as well as at-risk contracting.
Education
Required: Bachelor's degree in related field or ten years leadership experience can be accepted in lieu of Education.
Training
Required: None required.
Specialized Skills
Required: Knowledge of contract negotiations and contract legal review; strong skills in analytical/financial analysis; proficient in Excel, Word, and Power Point. Ability to build and maintain effective relationships within the Company and with customers (internal and external), physicians, clients, partners and vendors. Leverages interpersonal skills and technical knowledge to bring people and ideas together to perform effectively. Effectively influences others to achieve understanding acceptance and commitments to act in support of ideas, programs and products. Effectively expresses ideas verbally and in writing in individual and group settings. Creates an approachable and open environment and is collaborative in interactions. Successfully handles conflict Customer orientation that strives to meet and exceed meeting internal and external client and stakeholder needs. Prepared to drive change to improve performance, embrace innovation and address changing business conditions. Able to deal with expected and unexpected change. Maintains a strategic perspective on the business and helps support and influence others toward the accomplishment of strategic objectives.
Able to recommend results/decisions through data-driven as well as data analysis processes. Strong project management skills. Familiarity with best practices, project management and process improvement.
Licensure
Required: None required.
Work Environments - Functional Demand:
Sedentary - Very light energy level Lift 10 lbs. box overhead. Lift and carry 15 lbs. Push/pull 20 lbs. cart.
Physical Activity Requirements:
Bending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation
Physical Activity Lifting
Lifting (Floor to waist level) - Occasional 0-35%, Lifting (Waist level and above) - Occasional 0-35%
Sensory Requirements:
Color Discrimination, Depth Perception, Far Vision, Hearing, Near Vision
Environment Requirements:
Airborn Communicable Disease, Bloodborne Pathogens, Chemical, Dust Particular Matter, Extreme Noise Levels, Extreme Temperatures, Radiation, Uneven Surfaces or Elevations
Non-Discrimination Statement:
CHOC does not discriminate on the basis of age, race, color, religion, national origin, ancestry, marital status, genetic information, disability, sex, gender (including pregnancy, breastfeeding, childbirth, lactation or related medical conditions), gender identity or expression, medical condition, sexual orientation, veteran status, military or uniformed service member status, or other protected characteristics in accordance with state and federal laws.
We encourage individuals from all backgrounds to apply for positions at CHOC, even if your experience doesn't align perfectly with the listed qualifications for a particular role, as your unique experience may be a great addition to our culture for another one of our opportunities.
If you desire support or accommodations throughout the Talent Acquisition process, please inform your Talent Acquisition Partner.
Orange, California
Work Shift
Day - 08hrs (United States of America)
Why CHOC?
At CHOC, we strive to be the leading destination of children's health by providing exceptional and innovative care. We are responsible for the overall health of our community's pediatric population in our hospitals, clinics, and practices. And because of our breadth of care, your career at CHOC can be as diverse and fulfilling as you determine. CHOC's compensation structure, benefits offerings, and career development programs are geared to helping you achieve your professional and personal goals. Apply now to see where your career at CHOC can take you.
Job Summary
The Executive Director, Contracting & Managed Care develops, recommends and actively participates in specific contract strategy(s) or negotiations for new and renewing payer agreements for a multi-hospital and medical foundation system; initiate contract performance review, analysis and implementation of managed care contract negotiations, organize and lead interdepartmental teams in operationalizing managed care contracts and resolve identified managed care operational issues; participates in the development of contract management information systems. Supports the development and evaluation of new business relationships with physicians, medical groups and payers in order to increase service line volumes, overall commercial contract performance and market share. Provider network development and contracting to support at-risk products.
Pay Range
Minimum $203,507 Midpoint $269,630 Maximum $335,795
Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.
Experience
Required: Minimum ten years of experience in contracts and managed care in both hospital as well as heath plan or physician components under Fee for Service as well as at-risk contracting.
Education
Required: Bachelor's degree in related field or ten years leadership experience can be accepted in lieu of Education.
Training
Required: None required.
Specialized Skills
Required: Knowledge of contract negotiations and contract legal review; strong skills in analytical/financial analysis; proficient in Excel, Word, and Power Point. Ability to build and maintain effective relationships within the Company and with customers (internal and external), physicians, clients, partners and vendors. Leverages interpersonal skills and technical knowledge to bring people and ideas together to perform effectively. Effectively influences others to achieve understanding acceptance and commitments to act in support of ideas, programs and products. Effectively expresses ideas verbally and in writing in individual and group settings. Creates an approachable and open environment and is collaborative in interactions. Successfully handles conflict Customer orientation that strives to meet and exceed meeting internal and external client and stakeholder needs. Prepared to drive change to improve performance, embrace innovation and address changing business conditions. Able to deal with expected and unexpected change. Maintains a strategic perspective on the business and helps support and influence others toward the accomplishment of strategic objectives.
Able to recommend results/decisions through data-driven as well as data analysis processes. Strong project management skills. Familiarity with best practices, project management and process improvement.
Licensure
Required: None required.
Work Environments - Functional Demand:
Sedentary - Very light energy level Lift 10 lbs. box overhead. Lift and carry 15 lbs. Push/pull 20 lbs. cart.
Physical Activity Requirements:
Bending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation
Physical Activity Lifting
Lifting (Floor to waist level) - Occasional 0-35%, Lifting (Waist level and above) - Occasional 0-35%
Sensory Requirements:
Color Discrimination, Depth Perception, Far Vision, Hearing, Near Vision
Environment Requirements:
Airborn Communicable Disease, Bloodborne Pathogens, Chemical, Dust Particular Matter, Extreme Noise Levels, Extreme Temperatures, Radiation, Uneven Surfaces or Elevations
Non-Discrimination Statement:
CHOC does not discriminate on the basis of age, race, color, religion, national origin, ancestry, marital status, genetic information, disability, sex, gender (including pregnancy, breastfeeding, childbirth, lactation or related medical conditions), gender identity or expression, medical condition, sexual orientation, veteran status, military or uniformed service member status, or other protected characteristics in accordance with state and federal laws.
We encourage individuals from all backgrounds to apply for positions at CHOC, even if your experience doesn't align perfectly with the listed qualifications for a particular role, as your unique experience may be a great addition to our culture for another one of our opportunities.
If you desire support or accommodations throughout the Talent Acquisition process, please inform your Talent Acquisition Partner.