Senior Director, Managed Care Contracting

🕒 vor 29 Tagen

🌽 Illinois – Remote

🌽 Illinois – Remote

⏰ Vollzeit

🟠 Senior

👔 Direktor

👻 Geisterscore 12%

Was es bedeutet: die Wahrscheinlichkeit, dass für diese Stelle niemand wirklich einstellt.So liest du es: 60 % oder höher heißt, wir halten das für einen Geisterjob. Niedrigere Werte sind weniger bedenklich.Wie wir werten: Dauer offen, Neuveröffentlichungen, offene Stellen vs Teamgröße, wie schnell Stellen geschlossen werden, und ob ein Gehalt angegeben ist.Hinweis: eine Schätzung aus öffentlichen Daten, kein Urteil über das Unternehmen. Echte Stellen können hoch punkten, nutze es also als Hinweis, nicht als Fakt.

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Lumexa Imaging

WebsiteLinkedInAlle Stellen

1001 - 5000 Mitarbeiter

Gegründet 2018

🏥 Gesundheitswesen

🤝 B2B

Healthcare • B2B

Lumexa Imaging ist ein nationales Unternehmen für ambulante diagnostische Bildgebung, das Partnerschaften mit Gesundheitssystemen eingeht, um den Zugang zu fortschrittlicher medizinischer Bildgebung zu erweitern. Es betreibt über 185 ambulante Bildgebungszentren in 13 Bundesstaaten (darunter über 85 Zentren, die als Joint Ventures mit Gesundheitssystemen geführt werden), bietet zentralisierte Terminplanung, spezialisierte Radiologeninterpretationen (einschließlich Teleradiologie über das Connexia-Angebot) und nutzt KI sowie modernste Geräte, um die klinische Qualität und betriebliche Effizienz zu verbessern. Lumexa konzentriert sich auf das Patientenerlebnis, bequeme ambulante Versorgung, die kostengünstiger sein kann als Abteilungen für ambulante Untersuchungen in Krankenhäusern, und kooperative Joint Ventures mit Gesundheitssystemen.

Beschreibung

• Establish, build, and maintain positive working relationships with payer representatives and leadership within assigned geographies and/or projects. • Collaborate with joint venture managed care and other colleagues to accomplish joint managed care contracting and operational targets. • Lead negotiation and execution of contracts with managed care payers and other third parties. • Collaborate with internal and external legal counsel to review, evaluate, and document payer contract language against department and regulatory standards. • Perform ad hoc contract language review and analysis. • Serve as an internal resource for payer contract language questions and requests. • Work with financial analysts and department/company team members to prepare data and analysis for negotiations and trending claim or operational issues. • Guide department team members in planning contract negotiations and renewals, including historical performance assessment and opportunity identification. • Ensure completion of contracting for acquired or new facilities and practices. • Manage resolution of contract-related claims and operational issues with internal and external customers, Managed Care Operations, and revenue cycle teams. • Ensure new and revised contract terms are communicated to internal customers. • Develop and maintain department tracking documents. • Manage special projects and perform other assigned duties.

🎯 Anforderungen

• Bachelor's degree in Business Administration, Healthcare Administration, Finance, Law, or a related field required. • Master's degree in Business Administration (MBA), Healthcare Administration (MHA), Public Health (MPH), or Juris Doctor (JD) preferred. • Minimum of 10 years of progressively responsible experience in managed care contracting, payer relations, or healthcare reimbursement, including extensive experience negotiating complex payer agreements. • Minimum of 5 years of leadership experience with responsibility for managing teams, projects, and organizational initiatives. • Experience working with hospitals, physician organizations, integrated delivery systems, or large multi-specialty healthcare organizations preferred. • Demonstrated success developing and implementing contracting strategies that improve reimbursement, operational performance, and organizational outcomes. • Expert knowledge of managed care contracting principles, payer reimbursement methodologies, and healthcare payment models, including fee-for-service, value-based reimbursement, and alternative payment arrangements. • Comprehensive understanding of commercial, Medicare Advantage, Medicaid managed care, and other third-party payer contracting practices. • Strong knowledge of healthcare regulatory requirements affecting managed care contracting, reimbursement, and compliance. • Advanced contract negotiation, drafting, interpretation, and contract language analysis skills. • Exceptional financial and analytical skills with the ability to evaluate reimbursement methodologies, identify trends, and develop data-driven negotiation strategies. • Demonstrated ability to lead complex negotiations and influence internal and external stakeholders to achieve favorable outcomes. • Strong strategic planning, project management, and organizational skills with the ability to manage multiple priorities and deadlines. • Excellent written, verbal, and presentation communication skills. • Proven ability to build collaborative relationships across executive leadership, operations, finance, legal, revenue cycle, and clinical teams. • Strong leadership, coaching, and team development skills with experience fostering a high-performing, collaborative work environment. • Ability to exercise sound judgment, maintain confidentiality, and make informed decisions in complex or sensitive situations. • Proficiency with Microsoft Office applications, contract management systems, and healthcare financial and claims reporting tools.

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