Director of Managed Care Relationships

Description

Are you ready to be a difference maker? A change agent? Are you looking for an opportunity to do your life’s best work?

ScionHealth is recruiting for a Director of Managed Care Relations, DOMCR, to join our managed care team. This position will support our Southern California market. Preferred candidates will live in the general Los Angeles area as some light travel within the outlined market will be required.

ScionHealth, is focused on driving innovation and investing in people and technology to deliver compassionate patient care and excellent health outcomes in ways that lift a community and improve health equity. We operate 76 Specialty hospitals across the company and are growing. We believe that great work comes from passionate people who are inspired to give their best every day.

Job Summary

The Director of Managed Care Relations (DOMCR) works with Senior Directors of Managed Care to lead, develop, and execute on our Managed Care Market Strategies. Collaborates with market colleagues to identify and execute on business development and revenue growth opportunities and will work to resolve systemic clinical or operational challenges. The DOMCR will serve as a key market leader and a critical liaison between the market’s Managed Care payers and the markets’ operations and clinical teams by building trusted relationships and driving business. This role is both internal and external facing and focuses on developing and maintaining effective working relationships.

Primary Responsibilities

• Self-directed to build and maintain managed care payer relationships in support of the Managed Care strategy for each market to ensure (i) appropriate contact and communication at all necessary levels within the payor organization (e.g., contracting, medical management, discharge planning, etc.), (ii) communication of ScionHealth’s value proposition (iii) resolving “barriers to entry”, and (iv) consistency of messaging in general.
• Builds and maintains strong Managed Care payer relationships in support of the managed care strategy for each market with a focus on our value proposition.
• Acts as a liaison between the Managed Care department and internal and external stakeholders. Build trusted relationships.
• Owns and manages all aspects (including both clinical and operational matters) of assigned portfolio of Managed Care contracts and associated payer relationships.
• Sponsors and facilitates quarterly Joint Operation/Quality Meetings (JQCs) with Managed Care leadership and key decision-makers to identify and pursue business growth opportunities, resolve key clinical and/or operational challenges.
• Sponsors and facilitates Key Touch Point Meetings with critical external and internal customers monthly. Focuses on key decision makers in the payer community to identify and pursue strategic business growth opportunities.
• Educates and trains core group of market operations and internal support services on relevant elements of new or renegotiated contracts.
• Creates tailor made presentations/materials to help drive Managed Care business.
• Responsible for performing ongoing research to proactively identify new managed care business/opportunities.
  
  

Knowledge/Skills/Abilities

• Self-motivated and results oriented.
• Strategic thinker and takes initiative to seek out solutions.
• Strong organizational and interpersonal skills, including the ability to work collaboratively with various colleagues to achieve defined market-specific goals; high degree of comfort interacting with Medical Directors and Senior Utilization Management team in Managed Care Organizations.
• Ability to apply knowledge of payer contract terminology and payer reimbursement methodologies including managed care requirements and strategies.
• Ability to communicate in English effectively through verbal, written, and presentation form.
• Ability to work under stress and meet deadlines.
• Strong technical skills in regularly used applications, i.e., Excel, PowerPoint, Word, etc. Proficient in facilitation of virtual meetings (Teams, Zoom, etc.).
• Ability to manage and organize priorities, for multiple tasks, projects, and assignments simultaneously.
• Ability to travel occasionally: approximate percent of time required for travel: 30%
  
  

Qualifications

Education

• Bachelor's degree in business or related field.
  
  

Experience

• Five to seven (5 – 7) years of healthcare experience in the areas of managed care contracting, payer/provider relations, and/or business development.
• Clinical experience preferred but not required.
• Knowledge of Post-Acute Industry preferred but not required.