Associate Vice President of Managed Care

Summary

Job Description:

Baptist Health is looking for an Associate Vice President, Managed Care to join their Managed Care Department! This is a remote position with required residency in KY or IN.

This position is responsible for developing and implementing a business development strategy for third-party payers, including Commercial, Medicare and Medicare Advantage, Medicaid and Medicaid MCOs, and/or any other assigned payer sector or program. This business development strategy will be implemented to support all business units within Baptist Health providing services reimbursable by third-party payers, including hospital, medical group, ambulatory surgery centers, and other ancillary services, or units not yet established by Baptist Health.

This position's primary focus will be on driving revenue for the company, developing partnerships with managed care organizations, capitalizing on the geographic scope of BHS and optimizing value propositions within the payer community. This role provides strategic leadership, financial and administrative oversight of contracting with third-party payers on behalf of system working directly with BHS leadership.

Responsibilities include management of overall third-party relationships, establishing and achieving contracting goals and strategies, and negotiating and supporting all contracts with third-party payers for Baptist Health's business units, as well as the Clinically Integrated Network (CIN) and ACO. Ensure that the privacy and confidentiality of patient information is maintained. Manage the facilitation and implementation of activities related to the privacy and security of protected health information (PHI).

Qualifications:

• Bachelor's Degree in Business Administration, Finance or health related field required.
• Master's level degree in Business Administration or health related field strongly preferred.
• 10 years of experience within Managed Care with 3+ years of that experience in a leadership role
• Proficiency in Excel and ability to be trained in and understand how to optimize large data applications such as Qlik and Strata
• Direct experience with Medicare and other types of payment methodologies and understanding of ICD-10, DRG and CPT coding sufficient to perform job responsibilities
• Strong analytical skills to process and understand large and complex sets of data

Work Experience

Education