Regional Director Managed Care MWShawnee, KS

Regional Director Managed Care

Hospitals, medical centers and facilities need more than physicians, nurses and specialists delivering care to our patients. A truly successful health care organization needs a thoughtful, dedicated, steady and experienced team working behind the scenes to make sure communities around the country receive the health care they need.

If you've also been interested in working in the health care field but aren't a health care provider, a corporate career at AdventHealth may just be the perfect fit. We're a faith-based health care organization headquartered in Altamonte Springs, Florida. As a national leader in quality, safety and patient satisfaction, our 92,000 team members maintain a long tradition of whole-person health by caring for the physical, emotional and spiritual needs of every patient.

Start your journey with a health care career at AdventHealth Corporate.

Every day, our fellow team members show up to work, unified by one shared mission: Extending the Healing Ministry of Jesus Christ. As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam and patient room, we're committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.

The role you will contribute:

This position will provide leadership for managed care strategy, contracting and contract management for the five hospitals, ancillary services, and employed physicians.

The value you will bring to the team:

• Facilitates understanding of managed care within hospital departments, medical practices, and nursing and rehab centers.
• Manages relationships between managed care organizations, hospitals, ancillary services and employed physicians.
• Continuously re-evaluates managed care contracts, analyzing market share, profitability, and competitiveness.
• Other duties as assigned.
• Participates in leadership meetings and presents credentialing status for all groups.
• Audits and analyzes data for all physician/provider credentialing records, documents, and files.
• Programs applications to generate reports ensuring the accuracy of physician/provider records.
• Facilitates timely renegotiation and rate increases when appropriate.
• Monitors financial, operational, and strategic impact of managed care relationships to identify areas for improvement.
• Works with patient financial services on managed care claim-related issues.
• Assists the CFO with operational or special projects, including annual managed care budgets and market summary overviews.
• Coordinates and maintains credentialing documents necessary for credentialing and re-credentialing of all physicians/providers.

The expertise and experiences you'll need to succeed:

• Bachelor's Degree
• 5 plus years of health care leadership experience required in managed care with an emphasis on contracting, contract administration and strategic planning for hospital, ancillary and physician services

Preferred Qualifications:

• Master's Degree

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Managed Care

Organization: AdventHealth Corporate

Schedule: Full-time

Shift: 1 - Day

Req ID: 25035265

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.