Executive Director of Managed Care and Revenue Innovation

5 days ago


Miamisburg, Ohio, United States Kettering Health Full time

About Kettering Health

Kettering Health is a not-for-profit system of 13 medical centers and over 120 outpatient facilities serving southwest Ohio. Our mission is to provide high-quality care for every stage of life, with a service-oriented approach that prioritizes patient needs.

Job Summary

We are seeking an experienced Executive Director of Managed Care and Revenue Innovation to lead our third-party payer contracting activities and revenue recovery initiatives. This strategic leader will be responsible for developing and implementing contract strategies, negotiating with payers, and driving revenue growth across our acute care hospitals, ancillaries, ambulatory surgery centers, home health, DME, and physician services.

About the Role

  • Develop and execute contract strategies with third-party payers, employers, medical service organizations, and risk entities to optimize revenue recovery.
  • Lead the development and implementation of charge master activities, including interacting with hospital and physician teams to build charge pricing and strategies.
  • Manage the contract loading, modeling, evaluating, and performance of expected reimbursement for Kettering Health, ensuring timely and accurate payment.
  • Collaborate with Revenue Cycle to address denials and underpayments, and support Joint Operating Committee meetings and structures.
  • Provide strategic leadership in network strategy development, healthcare reform, and payment innovation, working closely with Hospital Presidents, Executive Leaders, and other stakeholders.

Requirements

  • Bachelor's degree required; Master's degree in business administration or Certified Public Account designation preferred.
  • Ten or more years of experience in managed care, preferably in healthcare provider or payer sites.
  • Professional affiliations with organizations like the American College of Healthcare Executives (ACHE) are a plus.

What We Offer

A competitive salary range of $120,000 - $160,000 per year, depending on experience, as well as opportunities for professional growth and development in a dynamic healthcare environment.



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