Fundamental Clinical & Operational Services is searching for a Vice President of Payor Strategy and Contracting based in our Sparks, Maryland office.
The Vice President of Payor Strategy and Contracting will oversee national and regional payor and contracting strategies with Managed Care Organizations (MCOs) including I-SNP programs. Will direct national and regional staff to build and coordinate MCO census activities to include physicians, physician groups, ACOs and appropriate external and internal case managers.
Client skilled nursing centers are located in multiple states.
Position Summary: Oversee and direct all areas of payor strategies and contracting with MCOs, I-SNPs and ACOs.Conduct regular program evaluations and adjust strategies as needed to meet objectives.Participate with multiple internal stakeholders in maximizing the number of referrals from affiliated key physicians, physician organizations, hospital accounts, managed care organizations and other local market sources in order to meet census and revenue goals.Ensure compliance with organizational policies and relevant regulations.Prepare routine reporting and analytics to support and justify recommendations for internal and external use.Lead the negotiation and contracting for all health plan relationships, from the ground up.Experience Required: Bachelor's Degree (Arts or Science) Required - plus 5+ years of managed care contracting and negotiation experience, representing a multi-site, multi-state skilled nursing health care specialty.Deep experience in understanding the healthcare field – understand parameters around how payers and providers are working, how they work together, and how analytics and aligning incentives is enabling transformation.Exceptional command of data and language and ability to navigate negotiations to achieve goals.Proven ability taking ownership over health plan relationships for the purposes of negotiations.Strong analytical skills, with extreme attention to detail, accuracy and accountability balanced with sound business judgment.Possess a strong detail orientation; seeks appropriate amount of data and information to make decisions; sorts and categorizes information quickly; prioritizes data points in decision making process.Must live in the greater Baltimore area and be willing to travel nationally - 75% travel to client facilities. Fundamental Clinical & Operational Services, LLC is an Equal Opportunity Employer. All of our team members are valued. Full-time team members are offered a comprehensive benefit package including medical, dental and vision insurance, life insurance for you and your dependents, long and short-term disability options, pet insurance discounts, 401(k), vacation/holiday/sick time, healthcare and dependent care flexible spending accounts, employee discount auto and home insurance, and tuition assistance. Salary is commensurate with experience.
#J-18808-Ljbffr