Senior Director, Managed Care Contracting

🕒 il y a 25 jours

🌽 Illinois – Distant

🌽 Illinois – Remote

⏰ Temps Plein

🟠 Senior

👔 Directeur

👻 Score fantôme 10%

Ce que ça veut dire : la probabilité que personne ne recrute vraiment pour cette offre.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Lumexa Imaging

Site WebLinkedInTous les Emplois

1001 - 5000 employés

Fondée en 2018

🏥 Santé

🤝 B2B

Healthcare • B2B

Lumexa Imaging est une entreprise nationale spécialisée dans l'imagerie diagnostique ambulatoire, construisant des partenariats avec les systèmes de santé pour élargir l'accès à l'imagerie médicale avancée. Elle exploite plus de 185 centres d'imagerie ambulatoire dans 13 États (y compris plus de 85 centres gérés en coentreprises avec des systèmes de santé), offre une programmation centralisée, des interprétations de radiologues superspécialisés (y compris la téléradiologie grâce à son offre Connexia) et utilise l'IA ainsi que des équipements de pointe pour améliorer la qualité clinique et l'efficacité opérationnelle. Lumexa se concentre sur l'expérience patient, les soins ambulatoires pratiques qui peuvent être moins coûteux que les départements ambulatoires des hôpitaux, et les coentreprises collaboratives avec les systèmes de santé.

Description

• 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.

🎯 Exigences

• 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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