Vice President (VP) of Managed Care
- Req. Number: 8700
- Address: 3200 Burnet Ave
- City, State: Cincinnati, OH
- Job Type: Full time
- Posted Date: 8/7/2023
Job Description
UC Health is hiring a full-time Vice President (VP) of Managed Care for the first shift at the UC Health Business Center.
The Vice President of Managed Care will support the UC Health delivering high-quality care to patients based on assessed needs, established standards of care and according to policy and procedures.
About UC Health
UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.
Responsibilities
The Vice President of Managed Care is responsible for enabling system strategic and financial priorities for the UC Health system through design and execution of managed care strategy. This position requires forward looking visioning, strategic thinking, and execution excellence to design and implement new and innovative opportunities for UC Health to improve value for patients, providers, and payers through managed care and payer strategy. This role involves payer relations, negotiation strategy, contract operations, and management of a team of managers and analysts to complete day-to-day execution of UC Health's payer contracts.
Qualifications
Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today!
UC Health is hiring a full-time Vice President (VP) of Managed Care for the first shift at the UC Health Business Center.
The Vice President of Managed Care will support the UC Health delivering high-quality care to patients based on assessed needs, established standards of care and according to policy and procedures.
About UC Health
UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.
Responsibilities
The Vice President of Managed Care is responsible for enabling system strategic and financial priorities for the UC Health system through design and execution of managed care strategy. This position requires forward looking visioning, strategic thinking, and execution excellence to design and implement new and innovative opportunities for UC Health to improve value for patients, providers, and payers through managed care and payer strategy. This role involves payer relations, negotiation strategy, contract operations, and management of a team of managers and analysts to complete day-to-day execution of UC Health's payer contracts.
- Serves as a crucial role in driving UC Health's financial performance by implementing effective managed care strategies, negotiating favorable reimbursement rates for UC Health, and collaborating with UC Health cross-functional leadership (e.g., RCM, Population Health, Legal, Finance, etc.) to ensure strong contract performance.
- Utilizes data and analytics to design and implement a managed care plan that aligns with UC Health's long-term goals.
- Engages in forward looking visioning and strategic thinking to design new and innovative opportunities to improve value for patients, providers, and payers through managed care and payer strategy.
- Utilizes knowledge of managed care reimbursement methodologies and insurance contracts including Commercial, Medicare, Medicaid, Professional, and VBC to stay updated on industry trends and regulatory changes to effectively engage in negotiation discussions with payers.
- Stays up-to-date on new healthcare regulations, industry guidelines, and compliance requirements related to managed care.
- Ensures UC Health adherence to these regulations in all managed care operations.
- Builds long-term relationships with payers and government agencies.
- Engages and maintains a positive relationship with peer network and community stakeholders to bolster support for UC Health's value proposition in the greater Cincinnati community.
- Navigates complex stakeholder dynamics to define and implement negotiation strategy and contracts.
- Pre-emptively troubleshoots issues in contract performance in collaboration with relevant peers (e.g., RCM).
- Proficient with managed care contract structures and financial analysis to effectively provide guidance to the managed care team.
- Guides and motivates a team of professionals, providing strategic direction, cultivating talent, and fostering a collaborative work environment.
Qualifications
- Master's degree required.
- Advanced degree (MBA, MHA, JD) from an accredited university preferred.
- Minimum of six (6) years demonstrated ability to engage in forward looking visioning and strategic thinking to design new and innovative opportunities to improve value for patients, providers, and payers through managed care and payer strategy.
- 11-15 years of experience preferred.
- Demonstrates effectiveness at navigating complex stakeholder dynamics to define and implement negotiation strategy and contracts.
- Ability to liaise effectively across cross-functional UC Health peers to enable negotiation strategy and contract performance.
- Progressive leadership growth leading a team of direct and non-direct reports.
Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today!
