Vice President Managed Care
LifePoint Health has an opportunity for a Vice President, Managed Care.
This position is based in Brentwood, TN at our Health Support Center, remote option available.
This high visibility, enterprise-wide leadership role with LifePoint Health, Inc. is responsible for the organization's overarching managed care strategy and payer relationships. Leading a team of talented managed care analytic and negotiating professionals, this position is the primary architect building and shaping LifePoint's managed care partnerships, as well as aligning the goals of operational leaders with LifePoint's key payer partners.
ESSENTIAL FUNCTIONS: To perform this job, an individual must perform each essential function satisfactorily 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 development 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 viability 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 impeding 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 vendors.
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 Recommended Practices.
SUPERVISORY RESPONSIBILITIES:
Manage the work of others, including planning, assigning, scheduling and reviewing work, ensures quality 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