VP Managed Care Contracting & Payor Strategy

Kpc Global Medical Centers Inc.; Corona (CA); On-site; USD 200,000 - 275,000; Full time

Job summary

KPC HQ in Corona, CA seeks a VP of Managed Care Contracting and Payor Strategy to lead the development and execution of contracting strategies for a multi-hospital system. You will report to the CFO and negotiate favorable terms with payors to drive revenue growth and strengthen financial performance.

The role requires a healthcare finance background, 10+ years in managed care contracting, 5+ years in leadership, with strong negotiation, communication, and strategic thinking skills.

Qualifications

• Bachelor's degree in healthcare administration, business, finance, or related field required.
• Master's degree preferred.
• Minimum of 10 years of experience in managed care contracting, payor strategy, or related field.
• Minimum of 5 years in a leadership role.
• Demonstrated success in negotiating and executing managed care contracts with payors.
• Strong understanding of healthcare finance, reimbursement models, and regulatory requirements.
• Excellent communication, negotiation, and relationship-building skills.
• Ability to work effectively with cross-functional teams and senior leadership.
• Proven leadership experience, with ability to motivate and develop a team.

Responsibilities

• Develop and implement a comprehensive managed care contracting strategy to drive revenue growth and financial performance for the multi-hospital system.
• Lead negotiations with payors to secure favorable contract terms, rates, and reimbursement structures.
• Build and maintain strong relationships with payors to ensure successful contract negotiations and ongoing collaboration.
• Monitor and analyze market trends, payor policies, and reimbursement rates to identify opportunities for improved financial performance.
• Collaborate with internal stakeholders to develop and implement strategies to optimize managed care contracts and payor relationships.
• Provide leadership and guidance to a team of managed care contracting professionals to ensure successful contract negotiations and execution.
• Oversee the development of contract performance metrics and reporting to track progress and identify areas for improvement.
• Serve as a subject matter expert on managed care contracting and payor strategy, providing guidance and support to senior leadership and other stakeholders.
• Stay current on industry trends, regulations, and best practices related to managed care contracting and payor strategy.
• Represent the multi-hospital system in negotiations with payors, industry events, and other relevant forums to promote the organization's interests and objectives.

Skills

Leadership

Strategic thinking

Negotiation

Communication

Cross-functional collaboration

Problem solving

Education

Bachelor's degree in healthcare administration, business, finance, or related field

Master's degree

Job description

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VP Managed Care Contracting & Payor Strategy

Full Time Dir/Exec KPC CORONA, Corona, CA, US

3 days ago Requisition ID: 1542

Salary Range: $200,000.00 To $275,000.00 Annually

Job Title: VP Managed Care Contracting and Payor Strategy

Location: California (specific location within the multi-hospital system to be determined)

Department: Finance

Reports To: Chief Financial Officer (CFO)

Location: Corporate HQ, Corona, CA

FLSA Status: Exempt

Company: KPC HQ

SUMMARY

The VP Managed Care Contracting and Payor Strategy will be responsible for leading the development and execution of managed care contracting strategies and payor relationships for a multi-hospital system in California. This individual will report to the CFO and work closely with senior leadership, finance, legal, and operational teams to negotiate favorable contract terms with payors, drive revenue growth, and improve financial performance. The VP Managed Care Contracting and Payor Strategy will play a critical role in driving revenue growth and financial performance for the multi-hospital system in California. This individual will lead the development and execution of managed care contracting strategies, negotiate favorable contract terms with payors, and build and maintain strong relationships with key stakeholders. The ideal candidate will have a strong background in healthcare finance, reimbursement models, and payor strategy, as well as proven leadership experience.

REQUIREMENTS

• Bachelor's degree in healthcare administration, business, finance, or related field required. Master's degree preferred.
• Minimum of 10 years of experience in managed care contracting, payor strategy, or related field.
• Minimum of 5 years in a leadership role.
• Demonstrated success in negotiating and executing managed care contracts with payors.
• Strong understanding of healthcare finance, reimbursement models, and regulatory requirements.
• Excellent communication, negotiation, and relationship-building skills.
• Ability to work effectively with cross-functional teams and senior leadership.
• Proven leadership experience, with the ability to motivate and develop a team of professionals.
• Knowledge of California healthcare market and payor landscape preferred.
• Deep understanding of CA managed care contracting and relationships including IPA’s; capitation/risk, safety net services and commercial managed care contracting
• Strategic Thinking
• Problem Solving
• Effective Communication

DUTIES AND RESPONSIBILITIES

• Develop and implement a comprehensive managed care contracting strategy to drive revenue growth and financial performance for the multi-hospital system.
• Lead negotiations with payors to secure favorable contract terms, rates, and reimbursement structures.
• Build and maintain strong relationships with payors to ensure successful contract negotiations and ongoing collaboration.
• Monitor and analyze market trends, payor policies, and reimbursement rates to identify opportunities for improved financial performance.
• Collaborate with internal stakeholders, including finance, legal, and operational teams, to develop and implement strategies to optimize managed care contracts and payor relationships.
• Provide leadership and guidance to a team of managed care contracting professionals to ensure successful contract negotiations and execution.
• Oversee the development of contract performance metrics and reporting to track progress and identify areas for improvement.
• Serve as a subject matter expert on managed care contracting and payor strategy, providing guidance and support to senior leadership and other stakeholders.
• Stay current on industry trends, regulations, and best practices related to managed care contracting and payor strategy.
• Represent the multi-hospital system in negotiations with payors, industry events, and other relevant forums to promote the organization's interests and objectives.