VP and HEAD of MANAGED CARE
– AMSURG in Nashville, Tennessee | Careers at NASHVILLE 20 Burton Hills Blvd Skip Branding Skip to Main Content Please Enable Cookies to Continue Please enable cookies in your browser to experience all the personalized features of this site, including the ability to apply for a job.
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VP and HEAD of MANAGED CARE
– AMSURG
Job Locations US-TN-Nashville Company Enterprise Requisition ID 2021-25738 Category Managed Care
Overview
and health systems across the country to provide and promote quality patient care.
We are the nationally recognized leader in the strategic and operations management of ASCs that deliver high quality, high value, same-day surgical services with a superior patient experience.
Launched in 1992 as an ASC industry pioneer, AMSURG is currently partnered with nearly 2,000 specialty physicians providing outpatient surgical services in more than 250 facilities in 34 states.
The Vice President , Managed Care is responsible for developing and implementing managed care strategies on behalf of our service lines, advancing enterprise initiatives and integration, managing payor relationships and underlying payor contracts nationally, leading department staff that are providing contract support, and developing strategies to grow the managed care portfolio.
Responsibilities
This role also develops annual strategic plans for each state within the defined geography and managed care portfolio, leads key payor negotiations with the goal of growing the managed care portfolio, develops staff negotiation skills, mitigates OON participating status, advances value based pricing logic, and delivers on key priorities.
Responsibilities:
Overall management of the AMSURG managed care portfolio; Advance enterprise initiatives and integration efforts; Negotiate contractual and reimbursement terms with market payors; Build the team and talent within Managed Care, including attracting, developing, and retaining staff; Monitor State and Federal legislation related to payment initiatives, and policy changes that could impact negotiations with health plans; Provide leadership to the integration of new joint ventures, affiliations, and partnership arrangements; Assess and review risks and opportunities across the enterprise related to payment reform, bundled payments, value-based payments, alternative payors, etc.; Develop tools and techniques that advance pricing objectives; Develop internal operating reports that quantify departmental and geographic portfolio performance; Establish and disseminate contracting guidelines with respect to third party payor contractual terms, reimbursement, provider enrollment and product participation; Conduct annual reviews of provider contracts; Analyze claims trend data and market information needed to support contract negotiations; Review and present financial data, utilization trends, and patient mix needed to negotiate and re-negotiate payor contracts; Maintain knowledge of payor products, enrollment statistics, and trends; Understand and keep apprised of issues and events that may have an impact on the business and industry; Work with the team on maintaining client satisfaction through internal and external communication; Identify contracting and payor disputes that may require legal action; Adhere to Information Security Policies and ensure Envision Healthcare and AMSURG are as secure as possible; Travel overnight and locally as needed; Regular and reliable attendance; Other duties as assigned.
Qualifications
Demonstrated track record of successful collaboration with physician partners and field operations, recognizing these partners as the life-blood of the business; able to develop and manage relationships both internally and with these partners; Successfully able to navigate a matrix environment and be seen as a key team player and business partner to other stakeholders, with proven ability to impact the overall business and optimize its performance; Possess a high adversity quotient and able to handle confrontations with poise and efficiency; Excellent written and oral communication skills, confident and impactful presenter; Driven by values and unimpeachable integrity, lead by example, and able to manage the dynamics around the maintenance and utilization of confidential information; Self-directed with a strong bias for action; Able to travel up to 50% nationwide; Excellent customer relationship and management skills.
Education/Experience:
Bachelor’s Degree from an accredited four year College or University; Master’s Degree preferred; 11+ years’ experience as described above, in roles of increasing responsibility that include supervision, significant managed care contracting experience with demonstrated ability in the areas of financial analysis, payment methodologies, contract language and negotiations.
We offer a comprehensive benefits package that includes full Medical, Dental and Vision benefits, company matching 401K, tuition reimbursement, Company paid Life Insurance and Long-term Disability, as well as generous PTO and Paid Holidays.
If you are ready to join an exciting, progressive company and have a strong work ethic, join our team of experts!
Envision Healthcare uses E-Verify to confirm the employment eligibility of all newly hired employees.
To learn more about E-Verify, including your rights and responsibilities, please visit http://www.dhs.gov/E-Verify
Envision Healthcare is an Equal Opportunity Employer.
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