Regional Director of Managed Care Contracting - East Coast Region

Envision Healthcare

This is a remote position

Envision Healthcare is a leading national medical group focused on delivering high quality care to patients when and where they need it most. More than 30,000 clinicians and clinical support teammates call Envision home. We welcome teammates of every background and work in communities that reflect the racial, ethnic, gender, sexual orientation, and economic diversity of our country.

Through Envision Physician Services and AMSURG, our clinician-led organization is changing the face of healthcare by delivering high-quality care that puts the patient first.

Envision’s core values drive continual advancement and ingenuity across the enterprise:

• Be Curious-embrace learning, seek out diversity of thought, listen openly, ask questions, and ask for feedback
• Instill Trust-have the hard conversation, presume good intent, honor commitments, and do the right thing for patients and each other
• Pursue Extraordinary-challenge the status quo, champion change, innovate and constantly aim higher
• Care Deeply-serve patients, partners, communities, and each other with empathy, compassion, and respect
• Embrace Teamwork-work cross-functionally, break down walls, develop others, be inclusive and unite to improve patient health
• Inspire Joy-seek fulfillment and the joy of medicine, appreciate others, celebrate wins, and promote wellness and belonging

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 available for an experienced Regional Director of Managed Care Contracting!

• Negotiating contractual and reimbursement terms with market payers.
• Managing existing contracts so allowable rates are achieved.
• Creating and maintaining relationships between operations, clients, and payers related to contract performance.
• Creating and maintaining strong inter-company relationships that facilitate the monitoring of payer issues such as provider participation status, market rate analysis, contract loading, and payment issues.
• Maintaining client satisfaction through internal and external communication.
• Assisting in the development of departmental goals, executing projects to achieve these goals, and working closely with others within the department to continuously monitor department performance.
• Preparing reports and presentations to monitor portfolio performance, yield, payer enrollment, payer mix, etc.
• Demonstrated proficiency with financial reports and modeling.
• Preparing internal training or educational tools as they related to health plan contracting and/or payment policies.
• Conduct onsite visits with payers, clients and operators that require market specific strategies.
• Assume responsibility for communication and execution of corporate initiatives.
• Provides input to the appropriate individuals to contribute to the development of corporate initiatives.
• Excellent communication skills (written and verbal) to enable the presentation of data in a convincing fashion.
• Ability to work in a matrix environment where multiple and competing customer demands are likely.
• Support and compile regional data collection for contracting assessment and strategic development.
• Self-directed with a strong bias for action.
• Excellent customer relationship / management skills.
• Demonstrated leadership and/or people management skills.
• Travel overnight and regionally, as needed.

• Skilled negotiator with a proven track record demonstrating ability to achieve results in challenging environments, including direct experience negotiating health plan and other third-party payer agreement
  terms on behalf of physician medical groups and/or ambulatory surgery centers
• Possess a strong understanding of the healthcare industry and payor-provider reimbursement methodologies as well as pricing strategies
• Develop and maintain a deep understanding of state and federal legislation related to payment initiatives and policy changes
• Excellent written and oral communication skills, confident and impactful presenter
• On a scale of Basic, Intermediate, and Advanced, must possess at least an Intermediate level of proficiency in Microsoft Excel (Pivot Table experience) and Word (redlining/tracking in agreements) as well as in Adobe PDF in addition to proficiency in Microsoft Outlook (email and calendar functions at a minimum)

• Bachelor’s degree required
• Five (5) years relevant experience negotiating health plan and other third-party payer agreement terms and language, financial analysis, payment methodologies
• Equivalent experience considered

Envision Healthcare 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 visit www.dhs.gov/E-Verify.