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UT Southwestern

Director Health Systems Managed Care Contracting

UT Southwestern, Dallas, Texas, United States, 75215


Director HS Managed Care Consulting

Requisition #819462

ABOUT UT SOUTHWESTERN MEDICAL CENTER

The University of Texas Southwestern Medical Center ranks among the top academic medical centers in the world. Its faculty members – who are responsible for a broad array of groundbreaking biomedical research advances – are respected for their dedication to teaching and patient care. The medical center has four degree-granting institutions: UT Southwestern Medical School, UT Southwestern Graduate School of Biomedical Sciences, UT Southwestern School of Health Professions and the UT Southwestern School of Public Health. The schools train about 3,700 medical, graduate, and allied health students, residents, and postdoctoral fellows each year.

UT Southwestern was named one of the Top 5 Best Organizations for Leadership Development (BOLD) Award winners by the National Center for Healthcare Leadership (NCHL) in 2022. The NCHL conducts a survey of health care organizations across the U.S. every other year to assess all components of organizations’ efforts to prepare and develop leaders.

A great medical center offers outstanding patient care in addition to fine teaching and innovative research. We emphasize compassionate medical treatment. UT Southwestern’s physicians are equipped to bring the latest laboratory findings to each patient. We provide inpatient care to nearly 117,000 people and oversee approximately 3 million outpatient visits annually. UT Southwestern has approximately 21,000 employees and an operating budget of approximately $4.1 billion.

JOB SUMMARY

This job provides advanced administrative guidance, operational management of staff responsible for development of health system contracting strategies, negotiations, coordinating facility and faculty business office issues with payors, producing supporting analytics, representing health system's evolving needs to stakeholders, and maintaining relationships with providers and payors for UT Southwestern Medical Center (UTSW).

ESSENTIAL FUNCTIONS

Job Duties

Conduct and successfully conclude, in a timely manner, contract negotiations that meet or exceed the financial and operational objectives of UTSW. Proactively enlist legal, operational, and financial input and support in order to achieve maximum benefit for the UTSW System.Work closely with UTSW faculty, facilities, and administrative teams to identify contracting needs and business office requirements. Whether through direct payor discussion or working through established payor interfacing structures, ensure UTSW's various and evolving needs are being addressed.Market and develop new business opportunities through pursuing managed care contracts. Develop and maintain positive business relationships with third party payors.Stay up to date on current and proposed federal and state healthcare policy and regulations that may impact UTSW. Work with UTSW leadership to develop and implement preferred strategies leading to continued UTSW success.Support analytics and ensures quality control of the reports produced. Oversee the development and routine production of financial reporting in support of contracting, monitoring, and planning activities.Facilitate UTSW's strategic pricing review by incorporating both internal input and available external resources. Work closely with UTSW leadership to process information that informs strategic decision making to best position UTSW for continued success.Monitor performance of contracts, regarding their financial performance, volume trends, product implementation, and acts as liaison to facility and faculty departments and payors.Manage analytic staff which includes recruitment, performance management, counseling and discipline, on-going training, and termination.Coordinate UTSW's interaction with other affiliated organizations' contracting staff. Attend project planning meetings of regional or national organizations involved in health services contracting.Develop and implement policies and procedures for operation of unit.Serve on, attend, and participate in UT Southwestern committees, meetings, and functions as requested by Administration.Perform other duties as assigned.

QUALIFICATIONS

Education and Experience

Required

EducationBachelor's Degree in Business Administration, Health Care Administration, or related field

Experience10 years of experience in contracting and business solutions in healthcare environmentIn addition, must have significant managed care contracting and analytic experience.

Preferred

EducationMaster's Degree in an appropriate field

Knowledge, Skills and Abilities

Work requires excellent negotiation skills.Work requires excellent analytical skills.Work requires familiarity with healthcare regulations and remaining current with their evolution over time.Work requires excellent oral and written communication skills.Work requires working knowledge of personal computer applications, including word processing, spreadsheet applications, graphics, publisher and database software.Work requires familiarity with DRG, HCPCS, CPT, and ICD-9 coding.Work requires ability to manage multiple priorities and deadlines.

PHYSICAL DEMANDS/WORKING CONDITIONS

Physical DemandsHandlingTalking

Working ConditionsOffice Setting

Travel RequirementsIn-person meetings at off-site locations will be required occasionally.

PACT STATEMENT

The following is the acronym, "PACT", and is fundamental to all non-clinical positions at UT Southwestern Medical Center:

P-Problem Solving :

Employees take ownership in solving problems effectively, efficiently, and to the satisfaction of customers, or managers. They show initiative in addressing areas of concern before they become problems.A-Ability, Attitude and Accountability :

Employees exhibit ability to perform their job and conduct themselves in a professional and positive manner reflecting a professional environment readily assuming obligations in a dependable and reliable manner.C-Communication, Contribution, and Collaboration :

Who are our Customers? Anyone who requests our help, needs our work product, or receives our services. Employees focus on customer service with creative solutions while improving the customer experience through clear, courteous, and timely delivery and communication. Sharing ideas with others helps expand our contribution to department goals.T-Teamwork :

Employees work to contribute to the department's success by supporting co-workers, promoting excellence in work product and customer service, and in maintaining a satisfying, caring environment for each other.

SalarySalary Negotiable

SecurityThis position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.

EEO Statement

UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status. Benefits UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:PPO medical plan, available day one at no cost for full-time employee-only coverage100% coverage for preventive healthcare – no copayPaid Time Off, available day oneRetirement Programs through the Teacher Retirement System of Texas (TRS)Paid Parental Leave BenefitWellness programsTuition ReimbursementPublic Service Loan Forgiveness (PSLF) Qualified EmployerLearn more about these and other UTSW employee benefits!

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