Accountable for the leadership and direction of all functional areas of Managed Care Contracting and Network Development for UF Health, including strategic positioning of the organization, contracting under traditional fee-for-service models, and positioning the organization to be successful under risk-based and population based models that optimize contract performance under both scenarios and maximize reimbursement.
Work closely with senior leadership to develop contracting strategy and to negotiate managed care contracts that position the University of Florida and UF Health as a premier provider for Florida and the Southeast. Educate system on contractual, legal and business requirements of managed care. Support the business and network development strategies of the system. Work closely with finance department's decision support director and UF decision support staff to optimize reimbursement rates and monitor contract performance. Supervise team leaders for contracting, contract management, PSA team and other managed care staff in Gainesville and Jacksonville markets.
Job Opening Qualifications
Minimum Education and Experience Requirements:
MBA or MHA preferred and 10 or more years of managed health care experience in a hospital, health system, large group practice or payer organization. Experience must demonstrate ability to function in a complex environment with strong management, communication and organizational skills with specific hospital and physician contracting experience, along with specific knowledge of strategic and business needs related to third-party payors contracting with a variety of provider organizations.
Must have knowledge of pricing, actuarial analysis, claims systems, management information systems, premium development, utilization review/case management, financial analysis and accounting practices for managed care firms and hospitals.
Must have a knowledge of the strategic and business needs related to third-party payors for various provider organizations, such as large multispecialty group practices, community providers, multi-hospital systems, behavior health and rehabilitation facilities, and academic health care.
Must have significant experience reviewing and negotiating financial and business terms of contracts with payors and/or providers.
We invite you to join our team! Our work and passion for excellence are intended to have an impact beyond the communities in which we serve. You may apply for a maximum of 10 positions at any given time. For general application process topics please review our Frequently Asked Questions. For technical assistance please contact Human Resources at 352-265-0441.
UF Health Shands Hospital is committed to diversity as a competitive advantage in attracting top talent from across the nation and around the world. We believe in sharing knowledge, learning from one another, valuing different opinions, and celebrating the things that make each one of us unique in our own right. UF Health Shands Hospital is an equal opportunity employer and drug-free workplace. Equal Opportunity Employer M/F/D/V