Director, Managed Care

United States·Fremontexecutive

OtherDirector

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Quick Summary

Requirements Summary

Required: Bachelor's degree (minimum ten 10 years’ experience can be substituted for formal education).

Technical Tools

OtherDirector

Salary Range: $196,000.00 - $294,000.00

Washington Hospital Healthcare System Job Description

Job Code: 714

The Director, Managed Care Contracting, contributes to WHHS’ growth

Job Title: Director, Managed Care Contracting

Position Summary

The Director, Managed Care Contracting, contributes to WHHS’ growth and profitability by providing contracting expertise to existing and new contractual relationships; and providing subject matter expertise, guidance, and direction regarding Managed Care Contracts. This includes coordination of commercial, Medicare Advantage, Medi-Cal Managed Care, Value-Based, Medicare Shared Savings, and other third party managed care contracts and Payor relation activities for Washington Hospital, Washington Township Medical Foundation, and DEVCO entities (surgery centers and other ancillary entities). The Director will be responsible for overseeing administration, review, and financial analyses of managed care contracts for the healthcare system, performing financial reporting and financial modeling for senior management strategic managed care decision making, and overseeing all Payor relations and managed care denial follow-up and resolution activities for the health care system. In addition to performing the essential functions listed below, may also be assigned other duties as required.

Statement of Accountability:

Reports to: Vice President & Chief Revenue Officer

Responsibilities

~1 min read

Regulatory Compliance

1. Demonstrates awareness of, and compliance with, patient safety and regulatory and licensing standards; i.e., TJC, Title 22, OSHA, HIPPA and Washington Hospital's numbered memorandums.