Director of Managed Care

Something special starts here.

You can’t define it, but you know it when you see it: the difference between an average life and the good life. When your cup is full – with joy, purpose and lifelong health – it shows. At LMH Health, we are all about healthy people, healthy communities and healthy futures, and that makes us your destination for an exceptional career. From flexible, work-life harmony to competitive pay and great advancement potential, find everything you’re looking for at LMH Health.

You'll find everything you’re looking for at LMH Health:

·             Join a team that cares about the community

·             Tuition reimbursement to support continuing education

·             Professional development and recognition

·             Excellent benefits

We’re looking for you.

Under direction of the Chief Financial Officer, the Director of Managed Care position manages all aspects of hospital and professional managed care contracting, including contract modeling, language, term and renewals, escalations, and negotiations with payers. Oversees payer underpayments, performance scorecards, and compliance with contract terms. Partners with internal stakeholders of LMH Health. A successful director in this role will understand prevailing hospital, physician and surgery center reimbursement, will have high competence in value based payer contracting, establish and achieve negotiation goals that represent the interests of LMH Health and our community, and possess analytical and organizational skills that support prioritization of payer relationship negotiation outcomes. If you are a lifelong learner, who thrives on building positive relationships, who wants to be somewhere in a role where they can make a difference, apply today.

Responsibilities

• This position is accountable to work with corporate and regional staff to ensure the accurate implementation, administration and ongoing monitoring of managed care contracts and corresponding processes and procedures at LMH Health
• This position will lead or participate in negotiating for all state level contracts
• Leads and/or assists in the strategic planning, analysis and negotiation of LMH Health and region specific managed care contracts on an as-needed basis under the guidance of the Chief Financial Officer 
• Develops and maintains relationships with staff of managed care plans in the regions or corporate level of the organization
• Assures that new contracts are rolled out in a timely, accurate manner
• Assists in Payor/plan dispute resolution projects as appropriate
• Responsible for distribution of managed care related information to hospitals, physician group leadership, ancillary leadership and regions
• Knowledge of general Federal and applicable State regulatory environment related to managed care and participates in legislative advocacy activities as appropriate

Qualifications

Required:

• Minimum 5-7 years Managed care experience required
• B.S. or B.A degree in finance, business, healthcare management, or related field                  

Our Cultural Beliefs

• Patient First. We consider the patient first in everything we do.
• Better Together. We actively strive to be a diverse LMH Health team that works together to achieve excellence.
• Listen/Speak Up. We embrace a diverse culture of open, respectful, well-intended communication where we listen, share, and value ideas to create equitable solutions.
• Innovate! We actively explore new ideas and approach change with agility and an open mind.
• Own It/Solve It. We hold ourselves accountable for our actions and we collaborate for solutions.
• In Joy. We create a workplace that is both fun and meaningful.

At LMH Health, we value inclusion and diversity. We are an equal opportunity employer and encourage all to apply. Employment is decided on the basis of experience and qualifications that meet the business need.