Vice President Managed Care and Payor Strategy Lead

2 weeks ago


Corona, California, United States KPC Health Full time
About KPC Health

KPC Health is a pioneering organization in the healthcare industry, with a successful track record of establishing integrated healthcare delivery systems. Our facilities serve a significant portion of California's population, totaling nearly ten million people.

Job Overview

The Vice President Managed Care Contracting and Payor Strategy will lead 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.

Key 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.
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, with at least 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.
Compensation
  • The compensation range for this role is $200,000 to $275,000 based upon skills, experience, and qualifications.
Key Competencies
  • Deep understanding of CA managed care contracting and relationships including IPA's; capitation/risk, safety net services and commercial managed care contracting
  • Strategic Thinking
  • Financial Acumen
  • Risk Management
  • Problem Solving
  • Effective Communication
  • Team Leadership
Working Conditions and Location
  • Office environment; may require occasional evening or weekend work during peak periods.
  • Ability to travel as needed within California and occasionally outside of the state.
  • Location is onsite at the headquarters in Corona, California.


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