Director-Managed Care Contracting

2 months ago

Chesterfield, United States Mercy Full time

We're a Little Different

Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.

At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.”


Overview:

This is a REMOTE position. Coworker must be located within a Mercy region (Missouri, Oklahoma, Arkansas).

The Director, Managed Care Contract Contracting contributes to Mercy's growth and profitability by providing contracting expertise to existing and new contractual relationships; and providing subject matter expertise, guidance, and direction regarding Managed Care contracts. This includes coordination of commercial, Medicare Advantage, Medicaid Managed Care and other third-party managed care contracts and payer relation activities. Performs duties and responsibilities in a manner consistent with our mission, values, and mercy service standards.

  • Negotiation of Managed Care Contracts: This includes routine contracting activities, maintaining strategic relationships, evaluating contracts, and acting as an internal resource in interpreting contracts.
  • Proactive Contract Renewal: Working closely with Managed Care and Finance leadership to develop contract proposals based on Ministry defined strategies, goals, and objectives.
  • Strategic Input: Providing input to Managed Care and Senior leadership relative to Ministry strategy and network positioning.
  • Growth and Acquisition Oversight: Coordinating with Managed Care Operations leaders to oversee growth and acquisition projects and initiatives.
  • Contract Administration: Ensuring appropriate dissemination of relevant contract details to all relevant internal departments and providing necessary tools to the Managed Care Operations team.
  • Contracting Prioritization: Supporting the prioritization of payer contract activities in collaboration with Managed Care leadership and key stakeholders.
  • Support for Special Projects: Supporting Managed Care strategy and contracting activities related to special projects, including acquisitions and addition of new services.
  • Data Interpretation: Interpreting data as provided for senior leadership, including market data, internal financials, and payer data.
  • Price Transparency: Supporting price transparency efforts and initiatives.
  • Payer Relations: Providing oversight and support to payer issues and escalations meetings and developing and maintaining appropriate relations with managed care payors.
  • Perform other duties as assigned.


Qualifications:

  • Experience: Minimum of 5 years previous experience in Managed Care contracting. In lieu of a degree, 9 years of experience will be considered.
  • Required Education: Bachelor's Degree
  • Preferred Education: Master's Degree in health care or business administration

We Offer Great Benefits:

Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period

We're bringing to life a healing ministry through compassionate care.

At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. We're expanding to help our communities grow. Join us and be a part of it all.


What Makes You a Good Match for Mercy?

Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We're also collaborative and unafraid to do a little extra to deliver excellent care – that's just part of our commitment. If that sounds like a good fit for you, we encourage you to apply.

EEO/AA/Minorities/Females/Disabled/Veterans

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