Regional VP, Managed Care Strategy & Contracts

Prime Healthcare; Chicago (IL); On-site; USD 134,000 - 194,000; Full time

Job summary

Prime Healthcare is seeking a Regional VP, Managed Care to lead and execute the organization\'s managed care strategy across payers and programs. The role focuses on negotiating contracts, shaping reimbursement models, and aligning strategies with financial goals.

Ideal candidate has 10+ years in managed care, an advanced degree preferred, and a proven ability to build relations with government agencies and payers, while communicating clearly with executives and clinical leadership.

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, goal oriented, ability to work independently.
• Excellent communication and presentation skills.
• Payer and provider experience preferred.

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.

Skills

Managed care knowledge

Strategic thinking

Independent work

Presentation skills

Communication skills

Education

Bachelor's degree

Master's degree preferred

Job description

Prime Healthcare is seeking a Regional VP, Managed Care to lead and execute the organization\'s managed care strategy across payers and programs. The role focuses on negotiating contracts, shaping reimbursement models, and aligning strategies with financial goals.

Ideal candidate has 10+ years in managed care, an advanced degree preferred, and a proven ability to build relations with government agencies and payers, while communicating clearly with executives and clinical leadership.