Providence Health & Services Executive Director, Regional Contracting Officer in Burbank, California

Description:

Providence is calling an Executive Director, Regional Contracting Officer to Providence Health & Services in Burbank, CA.

The Executive Director is the managed care leader for Providence St. Joseph Health (PSJH) responsible for working collaboratively with system and regional leadership to develop and execute PSJH contacting strategies. The Executive Director serves as the Chief Contracting Officer for the Region working directly with the Chief Executive Officer, Chief Financial Officer and Chief Strategy or Population Health Officer for the region. This position reports directly to the VP of Contracting and Payer Relations and serves on a team that will work together to identify current and future trends in the market and design approaches to contracting that are consistent with the organization’s mission and vision and changes in the industry. The Executive Director has a team of Contract Managers who are jointly responsible for negotiating the contracts for all revenue associated with national, regional, and local payers including commercial, Medicare Advantage, and managed Medicaid. The position is responsible for negotiating the various fee structures within each payer contract, including but not limited to, traditional fee-for-service arrangements, capitated arrangements, attributed risk arrangements, quality bonuses and shared or full risk terms for accountable lives.

The position is responsible for developing and maintaining strong relationships between the payers and the providers within our system and affiliated with PSJH. The position will work closely with our various ACO structures, physician groups, regional healthcare systems, and management structures to achieve the financial goals and strategic priorities identified by the system on an annual basis. The position will work closely with senior leadership at the System and regional levels, and with senior leaders in the Contracting Department, Population Health Division, and Operational Units of the Regional Delivery System and local ministries, including Finance, Revenue Cycle and Reimbursement to translate contract terms into clear actions that will allow us to perform from a financial, clinical, and operational standpoint. The Executive Director of Contracts must be able to balance the needs of the region, the system, and providers across the continuum without losing sight of our mission and core values as an organization. The Executive Regional Director for Orange County – High Desert will have a matrixed reporting relationship to the Chief Financial Officer for the Region.

In this position you will:

  • Provide internal and external strategic direction for PSJH while developing aligned relationships between the system and the regional leadership.

  • Partner with the regional leadership, develop the long term payer (i.e. managed care) strategy for the Region and leads the implementation of that plan.

  • Direct all third party contract renewals and manage negotiation activities in alignment with the Region and/or System objectives.

  • Lead the negotiation team and facilitate the implementation of contracts in the region.

  • Work with key Region leadership to define contracting principles and contracting strategies that further the mission, vision and values of PSJH.

  • Be responsible for developing and recommending strategic contract initiatives, desirable reimbursement methodologies and other arrangements that drive incremental volume, profitability and value.

  • Be capable of developing innovative risk sharing arrangements that increase opportunities for revenue growth and aligned incentives for appropriate management of the total cost of a population

  • Develop and negotiate rate structures within PPO, HMO and FFS products, as well as capitation, ACO, and other value based arrangements.

  • Partner with the Director of Analytics and Payer Performance to direct the evaluation of payment models and ensure contract modeling done by managed care plans or payers is verified by PSJH contract analytics team throughout the negotiations.

  • Work with the Contract Analytics and Administration team to present financial options to the Contract Strategy Councils, co-led by the Sr. Director and their regional partner.

  • Ensure timely renewals of agreements and that all agreements are implemented effectively to optimize effectiveness.

  • Act promptly on management questions and requests from key stakeholders.

  • Manage a team of contract managers and specialists who are responsible for supporting the contracting work for the region.

  • Direct the preparation and maintenance of department reports. Prepare periodic reports for top management, as required.

Qualifications:

Required qualifications for this position include:

  • Bachelor’s degree, preferably in healthcare administration, finance, business, or related field.

  • Master’s degree in Business Administration (MBA), Health Administration (MHA) (or equivalent experience).

  • Minimum seven to ten years’ experience in health care.

  • Minimum five years in leadership position-management experience.

  • Extensive experience leading high profile contract negotiations, business planning and strategic execution of initiatives, preferably for an integrated health care delivery system or managed care company.

  • Minimum five years’ experience working in a managed care environment on either the payor or provider side.

Preferred qualifications for this position include:

  • Experience with Medicare Advantage and/or Capitation.

About the department you will serve.

Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.

About Us

Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 82,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 600 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Finance & Accounting

Location: California-Burbank

Req ID: 159355