We are recruiting a Director of Managed Care Payor Relations to join ScionHealth.

Residence in the following states preferred: TX, TN, AR, LA or OK.

Summary:

Executes on local Market Managed Care Strategy by serving as a critical liaison between the market’s managed care payers and ScionHealth operators. Collaborates with market colleagues to identify new business opportunities and systematic clinical or operational issues with managed care contracts. Builds and manages relationships with managed care payers, with a focus on education around ScionHealth’s value proposition (as defined by the market’s local asset portfolio and competitive landscape) and resolution of clinical or operational issues. Drives increased managed care penetration across the continuum of care, as defined by the local market

Essential Functions:

Develops the local Market Managed Care Strategy, in collaboration with the Managing DOMCR and other market colleagues.

• Owns and manages all aspects of assigned managed care payer relationships in support of the Market Managed Care Strategy, including (i) identifying demand and scheduling meetings with the relevant payer contacts, (ii) creating tailored presentations / materials, (iii) seeking preparation and attendance support from appropriate colleagues based on the agenda, and (iv) leading the meeting

• Sponsors (ideally) quarterly JOC meetings with assigned managed care payers to identify and discuss strategies to resolve key clinical and operational issues, including (i) coordinating with the payer to prepare the agenda, (ii) inviting the appropriate Kindred stakeholders, (iii) preparing the necessary materials in support of the agenda, and (iv) facilitating the meeting

• Maintains relationships and resolves clinical and operational issues with assigned provider organizations under a contractual or risk-bearing agreement by acting as liaison with Managed Care Provider Relations staff. Dedicated to Hope, Healing and Recovery

• Sponsors and/or attends quarterly cross-divisional, cross-functional Managed Care Meetings (a forum for communication between the market’s key internal constituents), including assisting with compilation of required data and analysis

• Trains core group of market operators on relevant elements of new or renegotiated contracts, including preparation of training materials • Updates SharePoint with payer-specific activity for assigned accounts • Documents critical reporting capabilities for Kindred based on payers’ evolving data needs, as identified in JOC and other meetings

• Manages local and attends national conferences, as relevant

• Present Continuing Education Programs (CEU’s) to MCO’s relevant staff

• Attends relevant division district staff meetings

• Document goals, activities and accomplishments. Communicates and prepares reports on activity, industry trends, new business opportunities, statistical information/market share and other as required by the facility's leadership team and Sr Director of Managed Care.

• Maintains close involvement and active membership with State Self-Insured Employer Associations, Hospital Associations, Case Management Society of America Local/State chapters and others