Regional Director Managed Care MW
AdventHealth
**All the benefits and perks you need for you and your family:**
Benefits from Day One
Career Development
Whole Person Wellbeing Resources
Mental Health Resources and Support
**Our promise to you:**
Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that **together** we are even better.
**Shift** : Monday- Friday Full time 8am-5pm
**Job Location** : Merriam, KS
**The role you will contribute:**
This position will provide leadership for managed care strategy, contracting and contract management for the five hospitals, ancillary services, and employed physicians.
**The value you will bring to the team:**
+ Facilitates understanding of managed care within hospital departments, medical practices, and nursing and rehab centers.
+ Manages relationships between managed care organizations, hospitals, ancillary services and employed physicians.
+ Continuously re-evaluates managed care contracts, analyzing market share, profitability, and competitiveness.
+ Other duties as assigned.
+ Participates in leadership meetings and presents credentialing status for all groups.
+ Audits and analyzes data for all physician/provider credentialing records, documents, and files.
+ Programs applications to generate reports ensuring the accuracy of physician/provider records.
+ Facilitates timely renegotiation and rate increases when appropriate.
+ Monitors financial, operational, and strategic impact of managed care relationships to identify areas for improvement.
+ Works with patient financial services on managed care claim-related issues.
+ Assists the CFO with operational or special projects, including annual managed care budgets and market summary overviews.
+ Coordinates and maintains credentialing documents necessary for credentialing and re-credentialing of all physicians/providers.
**The expertise and experiences you'll need to succeed:**
+ Bachelor's Degree
+ 5 plus years of health care leadership experience required in managed care with an emphasis on contracting, contract administration and strategic planning for hospital, ancillary and physician services
**Preferred Qualifications:**
+ Master's Degree
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
**Category:** Managed Care
**Organization:** AdventHealth Corporate
**Schedule:** Full-time
**Shift:** 1 - Day
**Req ID:** 25035265
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.
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