Cardinal Health
Director, Managed Care - Navista
Cardinal Health, Juneau, Alaska, us, 99812
Cardinal Health - Director, Managed Care - Navista
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.The 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. The Director, Managed Care contributes to practice 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 role’s primary focus is to ensure optimal reimbursement for physician services and physician satisfaction as it relates to managed care contracts and operations. This position is responsible for administrative, strategic, business development, and contracting activities related to the Managed Care environment. They will be a seasoned leader and advisor, with proven experience supporting physicians in oncology to identify and realize payer specific reimbursement opportunities.This position reports to the VP, Operations for Navista and is a remote, work from home role with travel up to 50%.ResponsibilitiesDevelop and manage a team of managed care and credentialing specialists, vendors, and consultants.Periodically assess local and global market reimbursement rates for clinical procedures.Directly responsible for practice’s managed care strategy development and execution.Monitor relevant practice specific payer trends and advise on reimbursement risks.Negotiate contract renewal terms and develop new contracts based on contract goals.Lead proactive contract renewal by working closely with operations and finance leadership.Provide managed care consulting and leadership relative to business direction and strategy.Disseminate relevant contract details to all relevant departments for contract administration.Support clinic and admin departments in understanding operational issues.Direct the preparation and distribution of managed care reporting for senior 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 with negotiating managed care/health plan contracts.Experience facilitating billing and claims issues attributed to payor contracts.Demonstrate a high level of knowledge of health care delivery systems.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%).Anticipated salary range:
$102,000 – $182,005Benefits:Medical, dental and vision coveragePaid time off planHealth savings account (HSA)401k savings planAccess to wages before pay day with myFlexPayFlexible spending accounts (FSAs)Short- and long-term disability coverageWork-Life resourcesPaid parental leaveApplication window anticipated to close: 09/05/2024. 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 of thought, experience, and background. We celebrate the power of our differences to create better solutions for our customers.
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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.The 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. The Director, Managed Care contributes to practice 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 role’s primary focus is to ensure optimal reimbursement for physician services and physician satisfaction as it relates to managed care contracts and operations. This position is responsible for administrative, strategic, business development, and contracting activities related to the Managed Care environment. They will be a seasoned leader and advisor, with proven experience supporting physicians in oncology to identify and realize payer specific reimbursement opportunities.This position reports to the VP, Operations for Navista and is a remote, work from home role with travel up to 50%.ResponsibilitiesDevelop and manage a team of managed care and credentialing specialists, vendors, and consultants.Periodically assess local and global market reimbursement rates for clinical procedures.Directly responsible for practice’s managed care strategy development and execution.Monitor relevant practice specific payer trends and advise on reimbursement risks.Negotiate contract renewal terms and develop new contracts based on contract goals.Lead proactive contract renewal by working closely with operations and finance leadership.Provide managed care consulting and leadership relative to business direction and strategy.Disseminate relevant contract details to all relevant departments for contract administration.Support clinic and admin departments in understanding operational issues.Direct the preparation and distribution of managed care reporting for senior 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 with negotiating managed care/health plan contracts.Experience facilitating billing and claims issues attributed to payor contracts.Demonstrate a high level of knowledge of health care delivery systems.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%).Anticipated salary range:
$102,000 – $182,005Benefits:Medical, dental and vision coveragePaid time off planHealth savings account (HSA)401k savings planAccess to wages before pay day with myFlexPayFlexible spending accounts (FSAs)Short- and long-term disability coverageWork-Life resourcesPaid parental leaveApplication window anticipated to close: 09/05/2024. 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 of thought, experience, and background. We celebrate the power of our differences to create better solutions for our customers.
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