Vice President, Managed Care

POSITION SUMMARY:

This high visibility enterprise-wide leadership role with LifePoint Health Inc. is responsible for the organi-zations overarching managed care strategy and payer relationships. Leading a team of talented man-aged care analytic and negotiating professionals this position is the primary architect building and shap-ing LifePoints managed care partnerships as well as aligning the goals of operational leaders with Life-Points key payer partners.

ESSENTIAL FUNCTIONS: To perform this job an individual must perform each essential function satis-factorily with or without a reasonable accommodation.

Collaborate with senior leadership to develop future and execute current MC strategies
Work closely with value-based care and revenue cycle leadership to maximize total reimbursement yield and keep LifePoint assets network essential to payers
Integrate and align payer strategy with LifePoints growth and strategic objectives including value-based contracting strategies revenue cycle initiatives consumerism digital health service line de-velopment investments operational process improvement initiatives and M&A activity
Research and monitor insurance industry activities healthcare reform and payer strategy to inform managed care value-based care and revenue cycle priorities
Participate in committees to gain knowledge and influence in state and federal issues
Lead the managed care team in annual budgeting and planning work
Assume leadership role in complex high-impact negotiations with key payers to ensure financial via-bility and optimized contractual terms
Oversee the Development of monthly financial dashboards for key performance insight
Create clear insight in the form of quarterly reports to summarize managed care negotiating activities at the Division and individual market level
Lead the development of tools shedding light on the performance of key contracts
Work closely with RCM colleagues and health plan contacts to address chronic trended issues im-peding optimal contract yield
Take leadership role in all aspects of lawsuits arbitration mediation and settlements
Ensure managed care team is closely aligned with operations to develop and implement relevant managed care initiatives supporting areas of growth and opportunity
Create a sustainable managed care structure to ensure (a) proper training of new hires (b) resources for experienced team members and (c) a pipeline of talent for succession planning

Regular and reliable attendance.

Perform other duties as assigned.

Additional Information:

Position serves both internal co-workers and external customers clients patients contractors and ven-dors.

Access to and/or works with sensitive and/or confidential information.

Exhibit a comprehensive understanding of healthcare regulatory and compliance (e.g. HIPAA). Skilled in the application of policies and procedures. Knowledge of Business Office Standards and Recom-mended Practices.

SUPERVISORY RESPONSIBILITIES:

Manage the work of others including planning assigning scheduling and reviewing work ensures quali-ty standards. Responsible for hiring terminating training and developing reviewing performance and administering corrective action for staff.

KNOWLEDGE SKILLS & ABILITIES: The requirements listed below are representative of the knowledge skills and/or abilities required.

Education: Bachelors degree


Experience: Minimum of 7 years of managed care negotiation and contracting activities experience

Skills and Abilities:

Financial analysis
Contract modeling
Alternative payment methodologies
Key terms and conditions contract language
Negotiation strategy/tactics including escalated payer negotiation disputes
Relevant regulatory and compliance issues
Highly proficient working knowledge of Microsoft operating systems i.e. Word Excel
Must possess excellent written and oral communication skills
Must be self-motivated and able to meet deadlines
Optimistic solution-oriented collaborative by nature
Knows how to cultivate support and sustain a high-performing team
Possess good organizational skills with high executive function acumen


Choose one in each category (standard language):

Mathematical Skills
Business Mathematical Skills -- Ability to add subtract multiply and divide in all units of measure using whole numbers common fractions and decimals. Ability to compute rates ratios and per-centages and to draw and interpret graphs.

Computer Skills
Advanced Computer Skills -- Routine use of electronic mail and computer systems. Ability to incor-porate complex and complicated functions into documents spreadsheets databases and presenta-tions to support business objectives.

Communication
Organizational Communication -- Handles broad-based complex information across departments with company-wide impact. Presents to diverse audiences and can negotiate motivate and persuade others.

Decision Making
Organizational Impact -- Decisions have significant broad implications for the management and op-erations of a division. Job contributes to decisions on the overall strategy and direction of LifePoint.

Nature of Problems
Organizational Business Problems -- Problems are broad complex and abstract often involving company-wide issues. Must develop solutions using substantial creativity resourcefulness innova-tion negotiation and diplomacy.

Independent Judgement
Organizational Judgement -- Sets direction and vision for major departments or multiple depart-ments. Establishes priorities develops policies and allocates resources for LifePoint.

Planning/Organization
Organizational -- Prioritize organize and delegate project assignments company-wide: responsible for project outcomes.

PHYSICAL AND MENTAL DEMANDS: (standard language)

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

While performing the duties of this job the employee is occasionally required to stand; walk; sit for ex-tended periods of time; use hands to finger handle or feel objects tools or controls; reach with hands and arms; climb stairs; balance; stoop kneel bend crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 20 pounds. Repetitive motion of upper body re-quired for extended use of computer. Required specific vision abilities include close vision distance vision color vision peripheral vision depth perception and the ability to adjust focus.

WORK ENVIRONMENT AND TRAVEL REQUIREMENTS: (standard language)

Work environment characteristics described here are representative of those that an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

Works in well-lit ventilated and climate controlled office environment with routine office equipment; some equipment has moving mechanical parts.

In hospital environment may be exposed to hazards and unusual elements which may include but are not limited to bloodborne pathogens and / or contagious illnesses toxic chemicals and biohazardous materials which may require extensive safety precautions and the use of protective equipment.

Noise level in the work environment is typical for an office and/or hospital environment.

Minimum overnight travel (up to 15-20%) by land and/or air