Vice President of Managed Care and Network Development

Job Description

Job Description

Overview

NaphCare has an excellent opportunity for a Vice President of Managed Care and Network Development to join our Corporate Headquarters in Birmingham, AL .

The Vice President of Managed Care and Network Development is responsible for overseeing all national health care contracting activities across NaphCare’s Jail Division, Bureau of Prisons Division, and State Department of Corrections Division. This role provides leadership for provider network development, contract negotiations, reimbursement strategies, and departmental operations for a team of approximately 20 people.

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare.

Responsibilities

• Lead the team in evaluating, negotiating, and securing financially and administratively favorable contracts with new and existing community providers (hospitals and physician groups)
• Develop and support managed care strategies and initiatives to adapt to ongoing healthcare payment reforms and Medicare and Medicaid payment methodologies.
• Develop and foster effective collaboration between clinical departments, divisions, medical staff leadership, and other affiliated services to ensure an integrated approach to providing services and fulfilling the organization's goals.
• Oversee network development staff in the development of provider networks across all existing correctional contracts.
• Oversee new network development for new RFP responses.
• Perform periodic analyses of the provider network from a cost, coverage, and growth perspective.
• Manage budgeting and forecasting initiatives for product lines to network costs and provider contracts.
• Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
• Ability to travel 10%.

Qualifications

• Bachelor’s degree required with Master's/JD Degree preferred.
• Minimum of 10 years of experience in direct healthcare payor contract negotiations and a minimum of 7 years of operations and staff leadership/oversite.
• Strong knowledge of Medicare reimbursement methodology including prospective payment systems and Part B.
• Sound technology/software systems experience with good data analytic skill sets, ability to automate processes with technology, and advanced excel capabilities.
• Ability to lead multiple teams, manage multiple lines of business, and execute complex projects concurrently

• Strong communication and collaborative leadership skills.

• Ability to motivate, mentor, and develop staff.

• Strategic thinker with strong execution and organizational skills.

Why Join NaphCare?

NaphCare is one of the largest providers of healthcare services to correctional facilities throughout the US, and we are growing. If you have never considered a career in correctional healthcare, now may be the time! In addition to competitive salaries and generous employee benefits, we have opportunities for new graduates and experienced medical professionals, promote educational growth, and strongly support career advancement within the company.

NaphCare Benefits for Full-Time Employees Include:

• Health, dental & vision insurance that starts day one!
• Prescriptions free of charge through our health plan, beginning day one
• Lowest Cost Benefits!
• Employee Assistance Program (EAP) services
• 401K and Roth with company contribution that starts day one!
• Tuition Assistance
• Referral bonuses
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays
• Free continuing education and CMEs

If you would like to speak with me to learn more about this position and NaphCare, apply directly to the position to initiate the application process , and I’ll be in touch.

Equal Opportunity Employer: disability/veteran

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