Scripps Health
VP, Payer Relations
Scripps Health, San Diego, California, United States, 92189
Why join Scripps Health?
Award-winning Workplace#5 in Fortune Best Workplaces in Health Care 2023#78 in 2023 PEOPLE Companies that Care#95 in Fortune 100 Best Companies to Work for 2023Recognized by Newsweek as one of America’s Greatest Workplaces for Diversity in 2024Nearly a quarter of our employees have been with Scripps Health for over 10 years.The Vice President, Payer Relations has enterprise level responsibility for providing strategic and operational leadership in the development and execution of all types of payer contracting programs and provider partnership strategies for all lines of business (including commercial, senior, fee for service and value based).This role serves as the face of the system to all payers and their partners. Will lead cross-functional teams that have substantial impact on quality, revenue and growth across all Scripps Health business units. The Vice President is expected to exercise independent judgment in the day-to-day management of the organization's contracting and managed care activities.Responsibilities:Proactively support the Mission, Vision, Philosophy and Values of the Scripps Health organization.Ensure achievement of net revenue targets through contract negotiations with Commercial HMO/PPO payers, California Medi-Cal, Medicare Advantage Plans, County Medical Services, TriCare, and other purchasers.Support business unit-specific and medical group-specific payer contract needs.Apply financial and analytic acumen to work in order to achieve outcomes.Support physician network development and joint venture development through planning and payer contract support.Maintain close working relationship with affiliated physicians and groups.Work with management to ensure that the staff is appropriately trained.Advocate in the community regarding managed care regulations and government program reimbursement.Ensure regional compliance with local, state and federal regulations and standards.Participate in executive leadership and promote system-wide strategies.Prepare operating and capital budgets to ensure appropriate resource allocation.Lead the development of key performance indicators and management systems.Ensure established financial and quality goals are achieved.Participate in the formulation and/or update of the business unit operations and annual strategic plan.Meet regularly with clinical staff leadership to ensure optimal clinical outcomes.Provide leadership necessary to ensure the business unit is responsive to community healthcare needs.Ensure that patient care meets the highest professional quality standards.Provide leadership in corporate-sponsored project teams to support performance improvement efforts.This Vice President position is located at Scripps Health Administrative corporate office in La Jolla.Required Education/Experience/Specialized Skills:Master's Degree in a related field or an equivalent combination of education and experience.Five or more years of operations experience in healthcare administration.Demonstrated track record of being an accomplished executive with health care system experience.Extensive strategic planning and budget formulation skills.Strong leadership skills and effective team building.System mindset and support of Scripps Health values.Dedication to excellence and innovation regarding continuous quality improvement.Knowledge of local, state, and national healthcare markets.Commitment to positive employee relations and healthy community concepts.Excellent written, verbal, and listening communication skills.Commitment to continuing professional development.Knowledge of State and Federal Healthcare regulations.Preferred Experience:Executive experience developing and executing Southern California market strategy.Previous experience in business development, product development, and value-based contracting.Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.Position Pay Range: $00.01-$500.00/hour
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Award-winning Workplace#5 in Fortune Best Workplaces in Health Care 2023#78 in 2023 PEOPLE Companies that Care#95 in Fortune 100 Best Companies to Work for 2023Recognized by Newsweek as one of America’s Greatest Workplaces for Diversity in 2024Nearly a quarter of our employees have been with Scripps Health for over 10 years.The Vice President, Payer Relations has enterprise level responsibility for providing strategic and operational leadership in the development and execution of all types of payer contracting programs and provider partnership strategies for all lines of business (including commercial, senior, fee for service and value based).This role serves as the face of the system to all payers and their partners. Will lead cross-functional teams that have substantial impact on quality, revenue and growth across all Scripps Health business units. The Vice President is expected to exercise independent judgment in the day-to-day management of the organization's contracting and managed care activities.Responsibilities:Proactively support the Mission, Vision, Philosophy and Values of the Scripps Health organization.Ensure achievement of net revenue targets through contract negotiations with Commercial HMO/PPO payers, California Medi-Cal, Medicare Advantage Plans, County Medical Services, TriCare, and other purchasers.Support business unit-specific and medical group-specific payer contract needs.Apply financial and analytic acumen to work in order to achieve outcomes.Support physician network development and joint venture development through planning and payer contract support.Maintain close working relationship with affiliated physicians and groups.Work with management to ensure that the staff is appropriately trained.Advocate in the community regarding managed care regulations and government program reimbursement.Ensure regional compliance with local, state and federal regulations and standards.Participate in executive leadership and promote system-wide strategies.Prepare operating and capital budgets to ensure appropriate resource allocation.Lead the development of key performance indicators and management systems.Ensure established financial and quality goals are achieved.Participate in the formulation and/or update of the business unit operations and annual strategic plan.Meet regularly with clinical staff leadership to ensure optimal clinical outcomes.Provide leadership necessary to ensure the business unit is responsive to community healthcare needs.Ensure that patient care meets the highest professional quality standards.Provide leadership in corporate-sponsored project teams to support performance improvement efforts.This Vice President position is located at Scripps Health Administrative corporate office in La Jolla.Required Education/Experience/Specialized Skills:Master's Degree in a related field or an equivalent combination of education and experience.Five or more years of operations experience in healthcare administration.Demonstrated track record of being an accomplished executive with health care system experience.Extensive strategic planning and budget formulation skills.Strong leadership skills and effective team building.System mindset and support of Scripps Health values.Dedication to excellence and innovation regarding continuous quality improvement.Knowledge of local, state, and national healthcare markets.Commitment to positive employee relations and healthy community concepts.Excellent written, verbal, and listening communication skills.Commitment to continuing professional development.Knowledge of State and Federal Healthcare regulations.Preferred Experience:Executive experience developing and executing Southern California market strategy.Previous experience in business development, product development, and value-based contracting.Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.Position Pay Range: $00.01-$500.00/hour
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