Cardinal Health
Director, Managed Care - Navista
Cardinal Health, Montpelier, Vermont, us, 05604
Cardinal Health Director, Managed Care - Navista Montpelier, Vermont
At Navista, our mission is to empower community oncology practices to deliver patient-centered cancer care. Navista, a Cardinal Health company, is an oncology practice alliance co-created with oncologists and practice leaders that offers advanced support services and technology to help practices remain independent and thrive.Position OverviewThe Director, Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible for implementing strategic initiatives related to payer contracts, contributing to practice growth and profitability by providing contracting expertise to existing and new contractual relationships.This role’s primary focus is to ensure optimal reimbursement for physician services and satisfaction as it relates to managed care contracts and operations. Responsibilities include oversight of managed care and reimbursement operations across Navista practices and business lines directly or in partnership with other leaders.ResponsibilitiesDevelop and manage a team of managed care and credentialing specialists, vendors, and consultants.Assess local and global market reimbursement rates for clinical procedures and communicate findings with physician and executive leadership teams.Directly responsible for practice’s managed care strategy development and execution.Monitor relevant practice-specific payer trends and advise physicians and operations leadership on reimbursement risks.Direct daily operations of managed care contracting and payer relations.Negotiate contract renewal terms and develop new contracts based on defined goals.Lead proactive contract renewal efforts in collaboration with operations, revenue cycle, and finance leadership.Provide managed care consulting and leadership regarding business direction and network positioning.Disseminate relevant contract details to all relevant departments to facilitate contract administration.Support clinic and admin departments in understanding operational issues related to specific contracts.Prepare and distribute managed care reporting for senior Navista and physician leadership.Work effectively with multiple practice departments and external payers to develop contract opportunities.Support managed care strategy and contracting activities related to special projects.Provide leadership and support to payer issues and escalations meetings.QualificationsBachelor’s degree in business, healthcare administration, or related field required; master’s degree preferred.12+ years of experience in a contracting related field within a community physician office environment, preferably oncology.Experience negotiating managed care/health plan contracts.Experience facilitating billing and claims issues attributed to payor contracts.High level of knowledge of health care delivery systems and dynamics of hospital/physician relations.Outstanding organizational and time management skills.Excellent interpersonal and leadership skills.Great communication and presentation skills.Problem-solving mindset.Ability to travel as needed (up to 50%).Compensation and BenefitsAnticipated salary range: $102,000 – $182,005. Cardinal Health offers a variety of benefits including medical, dental, vision coverage, paid time off, health savings account, 401k savings plan, and more.Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.Cardinal Health supports an inclusive workplace that values diversity. We are an Equal Opportunity/Affirmative Action employer.
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At Navista, our mission is to empower community oncology practices to deliver patient-centered cancer care. Navista, a Cardinal Health company, is an oncology practice alliance co-created with oncologists and practice leaders that offers advanced support services and technology to help practices remain independent and thrive.Position OverviewThe Director, Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible for implementing strategic initiatives related to payer contracts, contributing to practice growth and profitability by providing contracting expertise to existing and new contractual relationships.This role’s primary focus is to ensure optimal reimbursement for physician services and satisfaction as it relates to managed care contracts and operations. Responsibilities include oversight of managed care and reimbursement operations across Navista practices and business lines directly or in partnership with other leaders.ResponsibilitiesDevelop and manage a team of managed care and credentialing specialists, vendors, and consultants.Assess local and global market reimbursement rates for clinical procedures and communicate findings with physician and executive leadership teams.Directly responsible for practice’s managed care strategy development and execution.Monitor relevant practice-specific payer trends and advise physicians and operations leadership on reimbursement risks.Direct daily operations of managed care contracting and payer relations.Negotiate contract renewal terms and develop new contracts based on defined goals.Lead proactive contract renewal efforts in collaboration with operations, revenue cycle, and finance leadership.Provide managed care consulting and leadership regarding business direction and network positioning.Disseminate relevant contract details to all relevant departments to facilitate contract administration.Support clinic and admin departments in understanding operational issues related to specific contracts.Prepare and distribute managed care reporting for senior Navista and physician leadership.Work effectively with multiple practice departments and external payers to develop contract opportunities.Support managed care strategy and contracting activities related to special projects.Provide leadership and support to payer issues and escalations meetings.QualificationsBachelor’s degree in business, healthcare administration, or related field required; master’s degree preferred.12+ years of experience in a contracting related field within a community physician office environment, preferably oncology.Experience negotiating managed care/health plan contracts.Experience facilitating billing and claims issues attributed to payor contracts.High level of knowledge of health care delivery systems and dynamics of hospital/physician relations.Outstanding organizational and time management skills.Excellent interpersonal and leadership skills.Great communication and presentation skills.Problem-solving mindset.Ability to travel as needed (up to 50%).Compensation and BenefitsAnticipated salary range: $102,000 – $182,005. Cardinal Health offers a variety of benefits including medical, dental, vision coverage, paid time off, health savings account, 401k savings plan, and more.Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.Cardinal Health supports an inclusive workplace that values diversity. We are an Equal Opportunity/Affirmative Action employer.
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