Providence Health & Services Executive Director Regional Contracting PSJH - Irvine, CA in Irvine, California
Providence is calling an Executive Director Regional Contracting PSJH to Providence Health & Services in Irvine, CA.
We are seeking an Executive Director Regional Contracting PSJH to be responsible for developing and maintaining strong relationships between the payers and the providers within our system and those providers affiliated with PSJH. The position will work closely with our various ACO structures, physician groups, regional healthcare systems, and management structures to achieve the financial goals and strategic priorities identified by the system on an annual basis. The position will work closely with senior leadership at the System and regional levels, and with senior leaders in the Contracting Department, Population Health Division, and Operational Units of the Regional Delivery System and local ministries, including Clinical Programs, Finance, Revenue Cycle and Reimbursement to translate contract terms into clear actions that will allow us to perform from a financial, clinical, and operational standpoint. The Executive Director of Contracts must be able to balance the needs of the region, the system, and providers across the continuum without losing sight of our mission and core values as an organization.
In this position you will have the following responsibilities :
Provide internal and external strategic direction for PSJH while developing aligned relationships between the system and the regional leadership.
In partnership with the regional leadership, develop the long term payer (i.e. managed care) strategy for the Region and leads the implementation of that plan.
Directs all third party contract renewals and manages negotiation activities in alignment with the Region and/or System objectives.
Leads the negotiation team and facilitates the implementation of contracts in the region.
Works with key Region leadership to define contracting principles and contracting strategies that further the mission, vision and values of PSJH.
Responsible for developing and recommending strategic contract initiatives, desirable reimbursement methodologies and other arrangements that drive incremental volume, profitability and value.
Required qualifications for this position include:
5 years in leadership position-management experience required
5 years’ experience working in a managed care environment on the provider side required.
7 years’ experience in health care
Extensive experience leading high profile contract negotiations, business planning and strategic execution of initiatives
Experience negotiating facility, professional, and continuum contracts for commercial, Medicare Advantage in a FFS or Capitated environment preferred (Capitation Experience Required for California).
thorough understanding of the financial arrangements of the hospital, health plan, and medical group in a capitated and non-capitated environments
Deep understanding of both fee-for-service and at-risk payer contracts.
Current knowledge of the changing health care landscape at the national and state level.
Strong working knowledge of health care contract language and negotiation strategies.
Thorough knowledge of laws and regulations relating to managed care and other payer functions
Ability to develop strong, trusting external relationships with payers
Ability to gain confidence and trust of leadership across the organization.
Creative, innovative thinker bringing new ideas and solutions to internal strategy discussions and contract negotiations.
Ability to work collaboratively and credibly across senior leadership both at the system and regional levels.
Capacity to analyze changes in policy and regulation and the impact on contracting strategy, current and future arrangements, and strategic goals.
Ability to articulate complex concepts in a clear, concise manner across system and regional leadership levels.
Ability to represent the Region effectively to regional, service area and system leadership, outside consultants, regulatory agencies and others.
Willingness to perform both independently on micro functions as well as cooperatively on macro projects.
Ability to manage change, promote positive interpersonal relationships
Excellent negotiation skills. Ability to create win-win outcomes in a contract negotiation
Excellent oral and written communication skills
Excellent financial and analytical skills with the ability to apply them effectively
Excellent organizational skills
Understand how to work effectively within a complex, matrix organization to approach the right people at the right time.
Ability to manage multiple initiatives simultaneously
Ability to close contract negotiations with successful results within tight timelines.
Preferred qualifications for this position include:
Bachelors Degree preferably in healthcare administration, finance, business, or related field.
Master’s degree in Business Administration (MBA), Health Administration (MHA) (or equivalent experience) preferred.
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer a full comprehensive range of benefits - see our website for details
As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.
Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 82,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 600 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Director / Executive
Req ID: 184885