[Hiring] Director, Managed Care Contracting @Local%20infusion

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking a Director of Managed Care that leads and oversees the operational, financial, programmatic, and employee-related activities within the Managed Care Contracting department. This is a new role within the organization that will help develop the vision and the execution of Payer Strategy. The Director will report to the SVP of Enterprise Growth and Strategy to build out the function in order to support rapid growth. This position is responsible for setting and monitoring goals aligned with Local Infusion's strategic objectives while providing leadership in day-to-day operations, budgeting, and financial oversight. • Initiate, develop, negotiate, and monitor contracts for Local Infusion, including contract renewals, amendments, and new agreements. • Engage directly with finance, field leaders, and other stakeholders to negotiate payment rates, structures, and contract terms. • Facilitate executive level relationships with health plan partners and effectively communicate value creation by Local Infusion. • Provide senior management with detailed reports and analysis on managed care performance, including key financial and operational KPIs. • Ensure the Managed Care team prioritizes resources for contract performance reporting and analysis. • Effectively communicate complex information to both technical and non-technical audiences. • Oversee claims processing, appeals management, and utilization management to prevent revenue leakage. • Facilitate communication with providers and affiliates regarding operational terms, legal requirements, and rates. • Coordinate the alignment and integration of Managed Care Contracting efforts with newly acquired organizations and new partnerships. • Establish and manage annual financial goals, utilizing benchmarking for target setting and financial forecasting. • Develop and manage annual operating and capital budgets, ensuring fiscal responsibility and meeting budget targets. • Guide managers in resource allocation based on patient volume, space availability, budget constraints, and program priorities. • Perform other related duties as required, including leading efforts to stay informed on changes to regulatory requirements. Qualifications • Bachelor's degree in a relevant subject area such as Accounting, Business Administration, Finance, Health Care required; Master's degree in a relevant subject preferred. • Minimum of 10 years of experience in managed care contracting or provider network management. • Experience in a large academic or complex health program that includes Managed Care experience. • Proven leadership experience in managed care contracting or a related field. • Proven experience negotiating contracts with Medicare Advantage plans, Medicaid Managed Care, and commercial payers. • Develop and optimize reimbursement strategies, including risk-sharing models and value-based payment structures. • Experience working with C-Suite Executives in a complex healthcare setting. • Ability to convey complex technical information in clear and concise communications. • Ability to identify issues, analyze data, develop, recommend, and implement solutions. • Possess initiative, decision-making skills and problem-solving abilities. • Familiarity with evolving healthcare legislation and compliance requirements is a plus. • Strong understanding of facility quality guidelines, compliance, and policy development. • Proven ability to work collaboratively with senior management, providers, and staff. Apply tot his job