Senior Director of Managed Care
LOCATION: Dignity Health
DEPARTMENT: Arizona Care Network (ACN)
SHIFT: 8HOUR, Day
EMPLOYMENT TYPE: Full Time
HRS PER PAY PERIOD: 80
JOB ID: 1700018374
The Arizona Care Network (ACN) is a clinically integrated (CI) physician network and Accountable Care Organization (ACO) sponsored by Dignity Health and Abrazo Health, a Tenet company. The Senior Director of Managed Care is an employee of MedProVidex, a wholly-owned subsidiary of Dignity Health.
The Senior Director of Managed Care is the point of contact for external organizations interested in engaging in an arrangement or partnership with ACN. The Senior Director of Managed Care must be familiar with CI, ACO, State and Federal programs, identify opportunities for contractual arrangements for ACN, and provide periodic reports to Boards of Managers/Directors and Leadership.
The Senior Director of Managed Care is responsible for leading and conducting managed care activities for Arizona Care Network, in partnership with the Managed Care leadership of both owner sponsor entities (Dignity and Abrazo). Through a collaborative Contract Strategy group, this individual coordinates the needs of each entity, ensuring that all ACO and facility requirements are addressed.
This position is the first point of contact organizations with questions or concerns regarding ACN, its functional strengths and priorities, and its willingness and ability to engage in health services arrangements with industry partners.
- Develop and enhance relationships with internal and external contacts. Proactively plan, prioritize, collaborate and communicate regarding projects, issues, and negotiations to ensure relationships are maintained
- Negotiate managed care contracts with new and existing payers (health plans and physician organizations) based on: strategic and financial goals, prior contract performance, projected contract performance, and thresholds approved by the ACN CEO and Board of Managers.
- Lead and coordinate the activities of personnel in the analysis, negotiation and implementation of existing contracts with payers, including the development and production of a variety of financial projections in support of contract negotiations and projects.
- Collaborate with other ACN leaders to plan and implement strategies to grow accretive market share and to increase the value of ACN’s services by developing innovative approaches to deliver quality care and to enhance the value proposition of ACN with all payer segment patients.
- Analyze contractual language for operational, financial, and ethical appropriateness. Determine compliance with established legal requirements and finalize contract in a manner consistent with the authority delegated to this position by ACN legal counsel.
- Direct the establishment and maintenance of internal communication and education processes that assure operations are conducted in compliance with contractual terms, and the establishment and maintenance of ongoing tracking and reporting systems and methodologies, in order to measure and document departmental and contract performance.
- Represent Arizona Care Network (ACN) in meetings with other organizations, associations, providers and payers regarding all aspects of ACO arrangements and managed care requirements.
- Organize and plan monthly conference calls with Hospital Presidents, physician organization leaders, CFO’s, Managed Care leaders and Strategy leaders and ensure adequate staff support to these conference calls. Make or oversee key presentations and recommendations to participants.
- Provide consultative support to ACN leadership and management with respect to managed care and related issues, including employee medical benefit plans and service line issues and new innovative strategies in which Dignity and Abrazo collaborates with health plans and/or medical groups to increase the value of services we provide.
- Responsible for collaborating with internal and external partners to plan and implement communications regarding ACN managed care activities.
- Other duties as assigned by ACN CEO.
A) EXPERIENCE: A minimum of 5 years leadership and management skills at a director level in managed care for a large hospital or hospital system, payer, clinically integrated network, or an equivalent combination of experience and education (preferred). A minimum 10 years leadership and management experience in a healthcare environment (required).
B) EDUCATION AND TRAINING: Bachelor’s Degree in business or related field or equivalent experience and record of accomplishments (required).
C) LICENSE, CERTIFICATION AND REGISTRATION: None
D) SPECIALIZED KNOWLEDGE AND SKILLS:
•Excellent written and verbal communication skills, including the ability to present ideas and concepts effectively across organizational levels.
•Strong negotiating skills, inclusive of interacting with organizations’ senior leadership.
•Demonstrated ability to analyze problems and issues from a variety of perspectives and to understand legal, risk, and operational impact of decisions.
•Possess a strategic and problem solving orientation and superior planning and organizational skills.
•Knowledge of regulatory compliance, including information privacy laws, access, release of information, and release control technologies.
•Working knowledge of functional relationships between departments within a healthcare or similar environment.
•Demonstrated competence with personal computers, networks, and Microsoft Office.
In business since 1993, Inland Health Organization of Southern California, Inc., now doing business as MedProVidex, is a wholly-owned subsidiary of Dignity Health. MedProVidex is a physician support organization that has historically provided physician practice and IPA management, but has expanded to support the infrastructure for Dignity Health’s Clinical Integration networks. In this capacity, MedProVidex provides local and corporate support resources to the Southern California Integrated Care Network (SCICN), the St. Rose Quality Care Network (SRQCN), Arizona Care Network (ACN), Sequoia Quality Care Network (SQCN), North State Quality Care Network (NSQCN), and future networks. MedProVidex is licensed to do business in California, Arizona and Nevada.
Dignity Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected Veteran status or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.
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