Reg Dir - Managed Care Contracting

SSM Health Care - Oklahoma City, OK

Full-time - Senior

Oklahoma City, OK

Hospitals

About the position

The Reg Dir - Managed Care Contracting at SSM Health is responsible for directing managed care activities and resources, monitoring financial performance of managed care contracts, and ensuring compliance with regulations. This senior-level position involves strategic planning, negotiation of contracts, and providing insights to senior management based on analytical data.

Responsibilities

• Develops and implements strategic and operational goals and objectives.
• Ensures policies and procedures are current and in compliance with applicable regulations and standards.
• Makes recommendations based on changes and trends in managed care and reimbursement.
• Provides mechanisms to solicit feedback on payer performance and departmental needs.
• Investigates problems, complaints, and deficiencies with payers and takes appropriate actions.
• Develops and evaluates departmental and payer benchmark key performance indicators.
• Provides reports and recommendations to senior management.
• Oversees the development, negotiation, implementation, monitoring, and management of managed care agreements.
• Negotiates and reviews direct employer payer contracts.
• Directs financial modeling specific to contracting efforts.
• Analyzes and interprets system-wide analytical information to provide insights to leadership.
• Serves as network contact for managed care contracting functions.
• Provides resolution to managed care contractual issues.

Requirements

• Bachelor's degree or equivalent years of education and experience.
• Seven years of experience, with five years in leadership.

Benefits

• Paid parental leave
• Health insurance
• Flexible Payment Options
• Upfront Tuition Coverage