Regional VP, Managed Care Contracting & Strategy

Prime Healthcare

Des Plaines (IL)

On-site

USD 134,000 - 194,000

Full time

21 hours ago

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Job summary

Prime Healthcare in Des Plaines, IL seeks a Regional VP, Managed Care to lead the organization’s managed care strategies, contracting, and value-based payment initiatives across a large health system. You will negotiate with payers, align programs across departments, and drive cost management, access, and quality improvements to enhance patient care and financial performance.

Responsibilities include negotiating contracts, developing payer relationships, and guiding policy changes while

Qualifications

At least 10 years related experience.
Minimum of Bachelor's degree required.
Master's degree in related field preferred.
In depth knowledge of managed care concepts, practices and procedures.
Strategic thinker with ability to work independently.
Excellent communication and presentation skills.

Responsibilities

Assesses and structures rate reimbursement levels for Managed Care Contracts.
Develops relationships with Governmental Agencies and Managed Care Entities.
Reviews, monitors, and disseminates changes with regard to Managed Care plan policy and provider manual changes.
Negotiates Medicaid Contracts and Supplemental Funding.
Assists Finance Department in projects assigned and disproportionate share.