Director, Managed Care
5 - 7 years experience •
Essen Health Care is an integrated healthcare delivery organization that provides high quality, compassionate, and accessible medical care to many of the most underserved residents of New York State. Guided by a population health model of care delivery, Essen?s patient-centric approach is focused on meeting patient needs in all care settings. With five clinical divisions, patient care is provided in medical offices, urgent care centers, hospitals, and nursing homes, as well as directly to patients in their homes. Founded in 1999, Essen clinicians provide care in all five boroughs of New York City
Due to growth and expansion, Essen Health Care is seeking a Director of Managed Care contracting. Reporting to the Chief Medical Officer, Director will be responsible for strategies and will need to establish strong working relationships and will be responsible for a wide variety of duties related to the development implementation and management of the Essen Health Care Managed Care Contracting function and Director will develop the strategic vision for Essen Health Care services
What you?ll be doing
? Manages effective execution of all managed care services throughout the organization, in line with strategic goals.
? Develops management information reports to analyze and evaluate the effectiveness and value outcome of all Managed Care Services.
Review contractlanguage, rate and fee proposals, complete market analysis comparisons and evaluate proposal and present to Essen Health Care senior leadership and membership
Reports managed care cost containment results to Administration team
Investigates, develops, and implements new managed care savings programs as appropriate.
Assures all Managed Care Services (internal and external) are compliant with State and Federal regulations.
Formulation of Budgets and Expense Management initiatives
Assist in the development of an overall strategy for the managed care activities for Essen Health Care
Bachelor?s Degree in Health Care field related preferred
Minimum of five years? (5) experience in Medicaid/Medicare, Managed Care is required.
Management skills and a strong knowledge of Provider Relations policies and procedures
Extensive knowledge, experience and expertise in managed care contracting negotiations, language, modeling analytics, reimbursement.