Corporate Director of Managed Care - Nexus Health Systems - Houston, TX

Description

This position is responsible for the overall payer strategy for Nexus Health System. This position will take the lead on payer relations and contract renegotiation in line with company goals and objectives. It is also important to maintain positive working relationships with these stakeholders by leading quarterly Joint Operating Committees and/or other methods of collaboration.

JOB SPECIFIC RESPONSIBILITIES:
• Planning, analysis, negotiation, and implementation for new and renegotiated contracts, including single care agreements
• Implement payer strategies to ensure optimal contracting and operational performance
• Serve as lead corporate liaison to all payers
• Optimize net revenue
• Review and update all contracts at least annually, including credentialing applications
• Attend key stakeholder community meetings
• Identifying, seeking and securing new opportunities as well as strengthening and maintaining existing relationships
• Manage day-to-day payer operations and contracting activities.
• Ensure entities at all levels of the organization will be informed about any and all terms of negotiated contracts and understand their role in ensuring contracts are implemented quickly and correctly
• Involve legal counsel if and when needed
• Assists the Central Billing Office with payment-related questions and resolution
• Assists in revenue validation routines
• Performs other duties as assigned

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Job Requirements

Experience

• 4-5 years of healthcare contracting or related experience
• Excellent interpersonal, communication, facilitation, and professional diplomacy skills
• Strong attention to detail with the ability to manage multiple priorities while meeting deadlines.
• Ability to foster working relationships with physicians, management and associated businesses
• Ability to respond to common inquiries or complaints from client, hospital or patients
• Ability to define problems, collect data, establish facts, and draw valid conclusions
• Possess strong communication skills to clearly and effectively communicate with physicians, management and hospital staff
• Proficiency with computers, software, and Electronic Medical Records (EMR) systems
• Highly organized with developed time management skills

Education Required

• 4-year degree required
• Master’s Degree preferred

Additional Information

LICENSURE/CERTIFICATION:
• none