VP of Managed Care

Location: California - Cerritos
Duration: Permanent - Full Time
Job ID: 20579655
Category: Nurse Practitioner - Family/Multi/General NP
Job Updated: 09/04/18
  Currently looking for a VP of Managed Care for a Specialty Infusion client in the LA market who will be responsible for building and implementing the payor strategy for all states and have primary responsibility for the authorization process. The VP of Managed Care will evaluate the current payor agreements and develop a comprehensive payor strategy which will include obtaining contracts from strategic payors in all markets nationwide.    Responsibilities of the VP of Managed Care include: Overseeing the authorization and billing issues while developing the overall and payor-specific strategies to maximize revenue opportunities.  Build sales and marketing tools to support this strategy, and work in a "hands-on" manner to gain access to and close targeted payor contracts.  Proactively negotiate contracts and manage all payor relationships while staying current with emerging trends and changes in policies that may affect the company's authorization, billing or reimbursement. Must be able to personally gain access to key payor decision makers, (i.e., network contracting executives, Medical Directors, Directors of Care Management, etc.) and to articulate Client's value proposition effectively. Secure contracts with commercial, managed Medicare, Medicare Part D and managed Medicaid payors at favorable rates. Supervise managed care Account Managers and a payor contracting specialist. The VP of Managed Markets will have the opportunity to build the business case to expand the size of the managed care account management team. Personally deliver key sales presentations in collaboration with the CFO, CCO, and CEO. Develop and execute strategies to improve access to decision makers within payor organizations that enable articulation of the value of its services and payor support Requirements of the VP of Managed Care Minimum of an undergraduate degree in a field relevant to sales and marketing is required. An advanced degree in business, marketing, public health, or a related field is also desirable, but not required. Minimum of 7 to 10 years of progressive leadership experience in managed markets contracting with a health services, or ancillary company. A successful track record of hiring and supervising a team is required. Significant experience directly selling into payor organizations with a track record of success within challenging payor organizations. Experience working for a managed care organization is an asset but not required.  

Contact information

Company: National Recruiters

Copyright © 1999 - 2018 - All Rights Reserved