Job Description

Warbird Healthcare Advisors actively seeks qualified candidates to be considered for a role as Interim Director of Managed Care for a healthcare client in Florida. The successful candidate will strategically lead the team that is responsible for negotiating payer agreements on behalf of the hospital, participate in the development, negotiation, implementation, monitoring and management of all third-party payor contracts, and help maintain a network of relationships with third-party payors.

Key Responsibilities

• Develop and implement the strategy, objectives, techniques, and tactics to achieve the strategic goals of the Organization.
• Collaborate with cross-functional teams to negotiate contracts and analyze provider networks, ensuring optimal value and quality.
• Strategically assess various contract relationships to determine appropriate changes based upon local market dynamics.
• Evaluate managed care contracts, performance, and reimbursement rates to identify areas for improvement.
• Stay abreast of changes in healthcare regulations and industry trends, and recommend adjustments to managed care strategies that anticipate changes that are forthcoming.
• Oversee the development and maintenance of provider relationships, fostering open communication and collaboration.
• Lead and mentor a team of managed care professionals, providing guidance, coaching and support to develop a team rooted in excellence and forward thinking.
• Analyze data and financial metrics to identify opportunities for cost savings and process improvements.
• Interface with executive leadership to provide regular updates, reports, and recommendations related to managed care strategies.
• Collect, organize, and timely submit all credentialing requests.
• Manage contracting for hospitals, physician, and ancillary providers.
• Assist in auditing of payments collaboratively with other departments to address and resolve operational issues as it relates to negotiated contract language.
• Prepare, analyze, review, and project financial impact of provider contracts and alternate contract terms.
• Develop the strategy to incorporate the delivery and reimbursement for new technologies into existing and future contracts.

Qualifications & Experience

• Bachelor’s degree in healthcare administration, business administration or finance, or equivalent experience required.
• Master’s degree in healthcare administration, business administration, or related field preferred
• Minimum of seven years’ experience in managed care and healthcare administration, working with third-party payers and managed care organizations is required.
• Keen negotiating skills and contract management skills.
• Experience with data analysis and financial modeling.
• Excellent analytical skills and problem-solving abilities, including the ability to interpret complex data and drive data-driven decisions.
• Knowledge of hospital and managed care finance, as well as healthcare regulations and compliance standards, including HIPAA and CMS guidelines.
• Excellent communication and interpersonal skills, with the ability to effectively collaborate with various stakeholders both internally and externally.

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