We are recruiting for a Senior Vice President (SVP), Payor Strategy and Managed Care. Preferred candidates will reside in the Louisville, KY or Nashville, TN area.
Summary:
Reporting to COO, and a member of the executive team, leads ScionHealth initiatives to develop strategic partnerships with managed care payers. The SVP will drive ScionHealth’s network and execute the strategic course in conjunction with our Revenue Cycle for the company in areas such as delivery systems and strategic pricing approaches for commercial payers. Additionally, the SVP will drive commercial contracts with Managed Care Organizations (MCOs), Accountable Care Organizations (ACO’s) and other commercial payers, contracting, and reporting on behalf of Scion enterprise.
Essential Functions:
Develops and executes an integrated managed care marketing strategic initiative across Scion divisions.
Proactively forge relationships with major national and multi-regional payers.
Partner with revenue cycle team to ensure optimal results of current and future state contracts.
Mentor, coach and inspire the Division Managed Care leaders to perform at the highest level and offer guidance to achieve a high level of performance.
Utilize data to offer recommendations to senior leadership around network strategy, team development and needed resources.
Guide the establishment of local, regional, and national contracts with managed care plans; acts as a resource to regional managers during contract negotiations.
Develop messaging and materials to help position Scion in key managed care markets.
Participate in Scion’s growth planning and development of complete referral networks.
Serve entire company as managed care expert and provide insight and recommendations on market dynamics internally and externally.
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Knowledge/Skills/Abilities:
Knowledge of managed care payer customer types, structure and market dynamics; established contact base with major insurers preferred.
Working knowledge of Medicare managed care program preferred.
Experience with leading company-wide initiatives a must, including ability to bridge across divisions and between Support Center and field teams.
Experience with post-acute and long-terms care providers and payer policies preferred, including Medicare and Medicaid.
Experience in building sustainable partnerships between payers and providers.
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Qualifications
Education:
Bachelor's degree in related field.
Master's Degree strongly preferred.
Licenses/Certification:
Experience:
10+ years in managed care contracting and marketing; both provider-side and managed care organization-side experience preferred.
Experience in a complex, matrixed organization is required.
Multi-state experience is strongly preferred.
Experience working with both provider and payer organizations is preferred.
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Depending on a Candidate’s qualifications, this position may be filled at a different level.
