Director-Managed Care Jobs

We're a Little Different

Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.

At Mercy, we believe in careers that match the unique gifts of unique individuals - careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its "Top 100 Places to Work."

Overview:

Coordinates and oversees value-based contracting activities for the Ministry. Responsible for negotiating and operationalizing value-based arrangements to include risk, gainshare, pay for performance, etc., for the Clinic and Facilities. Will be responsible for ensuring accurate and timely communications take place with all stakeholders both within Mercy and as well as external to Mercy, as appropriate. Performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.

Negotiate and renegotiate existing value-based agreements and implement new arrangements based on contract goals and parameters. Ensure all prospective stakeholders (Operations, Population Health/Primary Care, Finance, Medical Economics) are included in evaluation of newly proposed contractual arrangements.

Work directly with Population Health/Primary Care representatives to operationalize agreements to include coordinating regular touch base meetings with the payers to include JOCs. Function as facilitator of said meetings with ability to direct as needed.

Become knowledgeable with all external payer tools utilized for value-based arrangements, as needed, in order to generate necessary reporting for Mercy Leadership.

Establish close working relationship with key internal department leads such as Clinic Operations, Finance, Population Health in order to ensure contract parameters are being met. Disseminate relevant contract details to said departments, as well as others, as needed to facilitate the administration of the contract.

Provide strategic input to leadership relative to business direction and strategic positioning as they relate to managed care.

Assist Managed Care Operations with an assortment of operational issues as it relates to particular contracts and specific providers and/or patients (e.g., provider network issues, PCP assignments, etc.).

Recommend, develop and implement programs, services, and strategies related to managed care contracts.

Direct the preparation and distribution of a variety of reports for Mercy Leadership such as summarizing key elements of value-based initiatives and arrangements, analyses of performance to include such aspects as financial, utilization and quality performance. Provide input to finance department with respect to contract performance analysis and monitoring.

Engage in non-value-based contracting and operational activities, as needed.

Participate in a variety of special projects and duties as assigned.

Qualifications:

• Required Education: Bachelor's Degree in health care or business administration
• Preferred Education: Master's Degree in Business or Health Administration
• Experience: Minimum of five years' experience in managed care contracting, with emphasis on value based contracting experience. Must demonstrate organizational and interpersonal skills involving physicians, administration, and other health care professionals as required.
• Other: Demonstrates a high level of leadership skills to effectively interface between clinical and administrative leaders and coworkers. Demonstrates a high degree of independence in responding to the needs of leadership. Demonstrates a high level of analytical skill and ability to determine the appropriateness key financial terms related to contracts. Demonstrates an ability to problem-solve and resolve. Demonstrates well-developed oral and written communication skills. Demonstrates a high level of knowledge of the health care delivery systems, the local and national health care environment, and the dynamics of hospital physician relations.

We Offer Great Benefits:

Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period!

We're bringing to life a healing ministry through compassionate care.

At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. We're expanding to help our communities grow. Join us and be a part of it all.

What Makes You a Good Match for Mercy?

Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We're also collaborative and unafraid to do a little extra to deliver excellent care - that's just part of our commitment. If that sounds like a good fit for you, we encourage you to apply.