Regional Vice President, Managed Care Contracting

The Regional VP, Managed Care will develops and implement the managed care strategies for the organization. Develops and implements alignment models such as pay for performance, bundled payments and various forms of risk contracting. Negotiates and administers contracts with managed care payers. Responsible for planning, evaluating, and implementing the various managed care programs through the negotiation of contracts with various Managed Care entities.

Key Responsibilities & Duties:

• Assesses and structures rate reimbursement levels for Managed Care Contracts.
• Develops relationships with Governmental Agencies and Managed Care Entities.
• Reviews, monitors, and disseminates changes with regard to Managed Care plan policy and provider manual changes.
• Negotiates Medicaid Contracts and Supplemental Funding.
• Assists Finance Department in projects assigned and disproportionate share.

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

1.    At least 10 years related experience.

2.    Minimum of Bachelor's degree required.

3.    Master's degree in related field preferred.

4.    In depth knowledge of managed care concepts, practices and procedures.

5.    Strategic thinker, goal oriented, ability to work independently.

6.    Excellent communication and presentation skills.

Preferred qualifications:

1.    Payer and provider experience preferred.

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $134,160 to $194,313 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.