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Regional Director, Managed Care (South Atlantic Region)

Job Description

ABOUT US:

As the leader of rehabilitative care, Encompass Health offers both facility-based and home-based patient care through its national network of rehabilitation hospitals, home health agencies, and hospice agencies that spans 42 states and Puerto Rico. Setting the standard for providing excellent care, Encompass Health has earned its place among Modern Healthcare’s “Best Places to Work in Healthcare” and the Fortune “World’s Most Admired Companies” for 2021.

POSITION PURPOSE

The Regional Director, Managed Care works as an integrated part of the regional operations team to assist hospitals with managed care contracting with a focus on gaining access to new contracts, pricing improvements on existing contracts, compliant case growth, and other pricing and volume growth initiatives. The position also serves as the primary contact between the company and the managed care plans for assigned region.

RESPONSIBILITIES AND TASKS

  • Develops annual pricing budgets for managed care contracts within region.
  • Provides accurate and timely updates as part of the monthly KPjr process.
  • Monitors performance against targets; adjusts strategies accordingly so targets will be achieved.
  • Establishes individual goals and assists in the development of annual departmental goals.
  • Completes contract negotiations in a timely manner.
  • Identifies new contracts to add at specific hospitals.
  • Analyzes various reports to understand the impact of managed care pricing at the hospital level.
  • Advises hospitals on the impact of contract changes and how contractuals may be affected.
  • Identifies top contracts for each hospital and improvements necessary for positive financial impact.
  • Develops an annual managed care budget for each hospital in assigned region.
  • Reviews managed care contracting summary report to assess current performance against targets.
  • Analyzes contract volume and payment history to determine the value of individual contracts.
  • Meets with key groups such as Business Office Managers and Business Development Directors.
  • Uses technological applications to accomplish goals (UDS; ERT; HealthLeaders; CMS website, etc.).

*** We prefer this candidate to reside in the state of Georgia. 

QUALIFICATIONS

Minimum Qualifications:

  • Bachelor’s degree required; Master’s Degree preferred
  • 5 – 7 years of experience in hospital and/or provider contracting, provider relations, payor relations, and/or hospital related operations experience

Skills and Abilities:

  • Ability to review and analyze various forms of data.
  • Strong interpersonal skills.
  • Negotiation skills.
  • Competent in reviewing/negotiating legal verbiage in contracts.
  • Understanding of healthcare billing and reimbursement methodologies.
  • Detailed understanding of payer contracts, contract terms, and reimbursement structures.
  • Frequent travel may be required within designated region including overnight trips and trips to the Home Office.

BENEFITS

Enjoy competitive compensation and benefits that start day one of employment, including:

  • Affordable medical, dental and vision plans provided to meet the needs of full and part-time employees and their families.
  • Generous paid time off that increases with tenure.
  • Tuition reimbursement and continuing education opportunities.
  • Company-matching 401(k) and employee stock-purchase plans.
  • Flexible spending and health savings accounts.

 



Address: ,
Shift: Day Job
Schedule: Full-time
Job ID: 2133457