Cardinal Health
Director, Managed Care - Navista
Cardinal Health, Salem, Oregon, us, 97308
Cardinal Health Director, Managed Care - Navista Salem, Oregon Apply Now
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 implement strategic initiatives related to payer contracts, contributing to practice growth and profitability by providing contracting expertise. This includes coordination of commercial, Medicare Advantage, Managed Medicaid, and other third-party managed care contracts and payer relation activities.This role’s primary focus is to ensure optimal reimbursement for physician services and physician satisfaction related to managed care contracts and operations. Responsibilities include administrative, strategic, business development, and contracting activities related to the Managed Care environment. The Director will support physicians in oncology to identify and realize payer-specific reimbursement opportunities and oversee managed care and reimbursement operations across Navista practices and business lines.This position reports to the VP, Operations for Navista and is a remote 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.Develop strategies and action plans to implement opportunities for rate improvements.Monitor relevant practice-specific payer trends and advise physicians on reimbursement risks.Direct the daily operations of managed care contracting and payer relations.Negotiate contract renewal terms and develop new contracts based on contract goals.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 within a community physician office environment, preferably oncology.Experience with negotiating managed care/health plan contracts.Experience with facilitating billing and claims issues attributed to payer contracts.Demonstrate a high level of knowledge of health care delivery systems.Outstanding organizational and time management skills.Excellent interpersonal and leadership skills.Problem-solving mindset.Ability to travel as needed (up to 50%).Anticipated salary range:
$102,000 – $182,005Benefits:
Cardinal Health offers a variety of benefits including medical, dental, and vision coverage, paid time off, health savings account, 401k savings plan, and more.Candidates who are back-to-work, people with disabilities, and Veterans are encouraged to apply.Cardinal Health supports an inclusive workplace that values diversity.
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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 implement strategic initiatives related to payer contracts, contributing to practice growth and profitability by providing contracting expertise. This includes coordination of commercial, Medicare Advantage, Managed Medicaid, and other third-party managed care contracts and payer relation activities.This role’s primary focus is to ensure optimal reimbursement for physician services and physician satisfaction related to managed care contracts and operations. Responsibilities include administrative, strategic, business development, and contracting activities related to the Managed Care environment. The Director will support physicians in oncology to identify and realize payer-specific reimbursement opportunities and oversee managed care and reimbursement operations across Navista practices and business lines.This position reports to the VP, Operations for Navista and is a remote 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.Develop strategies and action plans to implement opportunities for rate improvements.Monitor relevant practice-specific payer trends and advise physicians on reimbursement risks.Direct the daily operations of managed care contracting and payer relations.Negotiate contract renewal terms and develop new contracts based on contract goals.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 within a community physician office environment, preferably oncology.Experience with negotiating managed care/health plan contracts.Experience with facilitating billing and claims issues attributed to payer contracts.Demonstrate a high level of knowledge of health care delivery systems.Outstanding organizational and time management skills.Excellent interpersonal and leadership skills.Problem-solving mindset.Ability to travel as needed (up to 50%).Anticipated salary range:
$102,000 – $182,005Benefits:
Cardinal Health offers a variety of benefits including medical, dental, and vision coverage, paid time off, health savings account, 401k savings plan, and more.Candidates who are back-to-work, people with disabilities, and Veterans are encouraged to apply.Cardinal Health supports an inclusive workplace that values diversity.
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