Executive Director, Managed Care
Reports to the Chief Business Development and Planning Officer health System. Responsible for the centralization of all managed care activities, implementing guidelines for PHO physician credentialing and re-credentialing, design, implementation and coordination of a utilization review function and related activities, including sale of such services to employers, third-party administrators and insurance companies. Negotiates contracts with insurance companies/payers for Health System services. Conducts system-wide managed care activities and group credentialing and contracting. Directs a system-wide utilization review/ quality management program. Oversees sales function that sells system services to area businesses. Assists in arranging affiliation relationships with otherhealthcare and healthcare-related organizations, oversees affiliation relationships, and new business development
What are the 3-4 non-negotiable requirements on this position?
Successful completion of a Bachelor's degree in Business, Economics, Marketing or a related field. A previous successful contract negotiating record is required. Five to seven years of supervisory/leadership experience is required.
What are the nice-to-have skills?
Master's Degree in Business or Health Administration; and five to seven years of experience in managing managedhealthcare programs, traditional health insurance, marketing and hospital/physician relations is preferred.