Envision Healthcare

  • VP, MANAGED CARE

    Job Locations US-TN-Nashville
    Company Enterprise
    Requisition ID
    2019-21929
    Category
    Managed Care
  • Overview

    Envision Physician Services is a multispecialty physician group and practice management company. Established in 1953, our organization provides anesthesia, emergency medicine, hospital medicine, radiology, primary/urgent care, surgical services, and women’s and children’s health services to hospitals and health systems nationwide. Sheridan Healthcare, EmCare, Reimbursement Technologies and Emergency Medical Associates have recently joined forces to form Envision Physician Services.  As one organization, we now provide a greater scope of service than any other national physician group. Our collective experience from hundreds of local, customized engagements, culture of continuous lean process improvement, and team of experts in the business of healthcare enable us to better solve complex problems and consistently give healthcare organizations confidence in our execution. Our combined organization serves more than 780 healthcare facilities in 48 states and the District of Columbia. 

    If you are looking for a stable, fast-paced, growing company in the healthcare industry that is committed to innovation, excellence and integrity, then this may be a great next step in the advancement of your career.

     

    We currently have an exciting opportunity for the Vice President, Managed Care located in Nashville, TN.

     

    The Vice President, Managed Care is responsible for managing payer contracting pertaining to a defined geography, i.e., managed care portfolio; advancing enterprise initiatives and integration; managing payer relationships pertaining to defined geography and underlying payer contracts; and, providing leadership to department staff providing contract support. Develop strategies for growing the managed care portfolio. Develop annual strategic plans to each state within the defined geography and managed care portfolio. Lead key payer negotiations the goals of growing the managed care portfolio; develop staff negotiation skills; mitigate OON participating status; advance value based pricing logic; and, deliver on key priorities.  This position requires up to 50% travel.

    Responsibilities

    • Overall management of the regions managed care portfolio.
    • Advance enterprise initiatives and integration.
    • Monitor state and federal legislation related to payment initiatives, policy changes that could impact negotiations with health plans.
    • Provide leadership to the integration of new joint ventures, affiliations and partnership arrangements.
    • Assess and review risks and opportunities across the enterprise related to payment reform, bundled payments, value-based payments, etc.
    • Develop tools and techniques that advance pricing objectives.
    • Develop internal operating reports that quantify departmental and geographic portfolio performance.
    • Establish and disseminate contracting guidelines with respect to third party payer contractual terms, reimbursement, provider enrollment and product participation.
    • Negotiating contractual and reimbursement terms with market payers.
    • Conduct annual reviews of provider contracts.
    • Analysis claim trend data and/or market information needed to support contract negotiations.
    • Review and present financial data, utilization trends and patient mix needed to negotiate and re-negotiate payer contracts.
    • Maintain knowledge of payer products, enrollment statistics, and trends.
    • Understand and stay abreast of issues and events that may have an impact on business and industry.  
    • Work with the team on maintaining client satisfaction through internal and external communication.
    • Identify contracting / payer disputes that may require legal action.
    • Travel overnight and locally as needed.
    • Other duties as assigned.

    Qualifications

    To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required.

     

    Education/Experience:

    • 11+ years relevant experience required to include supervisory experience, significant managed care contracting experience with demonstrated ability in the areas of financial analysis, payment methodologies, contract language and negotiations
    • Equivalent experience considered
    • Bachelor’s degree required
    • Master’s degree preferred

     

    Required:

    • Must be fluent in Microsoft Office applications
    • Position requires overnight travel up to 50% of the time

     

     

    We offer a comprehensive benefits package that includes full Medical, Dental and Vision benefits effective on your first day of employment. A company matching 401 K, tuition reimbursement, company paid Life Insurance and Long-term Disability, as well as generous PTO and Paid Holidays

     

    If you are ready to join an exciting, progressive company and have a strong work ethic, join our team of experts! We offer a highly competitive salary and a comprehensive benefits package.

     

    Envision Physician Services uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visitwww.dhs.gov/E-Verify

     

    Envision Physician Services is an Equal Opportunity Employer.

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