Cardinal Health
Director, Managed Care - Navista
Cardinal Health, Lincoln, Nebraska, United States, 68511
Cardinal Health - Director, Managed Care - Navista
Location: Lincoln, NebraskaAt 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, contributing to practice growth and profitability by providing contracting expertise to existing and new contractual relationships, and providing subject matter expertise regarding managed care contracts.This role focuses on ensuring optimal reimbursement for physician services and physician satisfaction as it relates to managed care contracts and operations. Responsibilities include administrative, strategic, business development, and contracting activities related to the Managed Care environment.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.Direct the daily operations of managed care contracting and payer relations.Negotiate contract renewal terms and develop new contracts.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.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.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, preferably in oncology.Experience with negotiating managed care/health plan contracts.Experience with facilitating billing and claims issues attributed to payor contracts.Demonstrate knowledge of health care delivery systems and 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%).Anticipated salary range:
$102,000 – $182,005Benefits:
Cardinal Health offers a wide variety of benefits and programs to support health and well-being including medical, dental, and vision coverage, paid time off, health savings account (HSA), 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 of thought, experience, and background.
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Location: Lincoln, NebraskaAt 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, contributing to practice growth and profitability by providing contracting expertise to existing and new contractual relationships, and providing subject matter expertise regarding managed care contracts.This role focuses on ensuring optimal reimbursement for physician services and physician satisfaction as it relates to managed care contracts and operations. Responsibilities include administrative, strategic, business development, and contracting activities related to the Managed Care environment.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.Direct the daily operations of managed care contracting and payer relations.Negotiate contract renewal terms and develop new contracts.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.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.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, preferably in oncology.Experience with negotiating managed care/health plan contracts.Experience with facilitating billing and claims issues attributed to payor contracts.Demonstrate knowledge of health care delivery systems and 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%).Anticipated salary range:
$102,000 – $182,005Benefits:
Cardinal Health offers a wide variety of benefits and programs to support health and well-being including medical, dental, and vision coverage, paid time off, health savings account (HSA), 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 of thought, experience, and background.
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