VP Managed Care Contracting & Payor Strategy

Job Description

Job Description

Job Title: VP Managed Care Contracting and Payor Strategy

Location: California (specific location within the multi-hospital system to be determined)

Department:  Finance  

Reports To:  Chief Financial Officer (CFO)  

Location:  Corporate HQ, Corona, CA

FLSA Status: Exempt  

Company: KPC HQ

SUMMARY

The VP Managed Care Contracting and Payor Strategy will be responsible for leading the development and execution of managed care contracting strategies and payor relationships for a multi-hospital system in California. This individual will report to the CFO and work closely with senior leadership, finance, legal, and operational teams to negotiate favorable contract terms with payors, drive revenue growth, and improve financial performance. The VP Managed Care Contracting and Payor Strategy will play a critical role in driving revenue growth and financial performance for the multi-hospital system in California. This individual will lead the development and execution of managed care contracting strategies, negotiate favorable contract terms with payors, and build and maintain strong relationships with key stakeholders. The ideal candidate will have a strong background in healthcare finance, reimbursement models, and payor strategy, as well as proven leadership experience. 

REQUIREMENTS

• Bachelor's degree in healthcare administration, business, finance, or related field required. Master's degree preferred.
• Minimum of 10 years of experience in managed care contracting, payor strategy, or related field.
• Minimum of 5 years in a leadership role.
• Demonstrated success in negotiating and executing managed care contracts with payors.
• Strong understanding of healthcare finance, reimbursement models, and regulatory requirements.
• Excellent communication, negotiation, and relationship-building skills.
• Ability to work effectively with cross-functional teams and senior leadership.
• Proven leadership experience, with the ability to motivate and develop a team of professionals.
• Knowledge of California healthcare market and payor landscape preferred.

Key Competencies: 

• Deep understanding of CA managed care contracting and relationships including IPA’s; capitation/risk, safety net services and commercial managed care contracting
• Strategic Thinking
• Financial Acumen
• Risk Management
• Problem Solving
• Effective Communication
• Team Leadership

DUTIES AND RESPONSIBILITIES

• Develop and implement a comprehensive managed care contracting strategy to drive revenue growth and financial performance for the multi-hospital system.
• Lead negotiations with payors to secure favorable contract terms, rates, and reimbursement structures.
• Build and maintain strong relationships with payors to ensure successful contract negotiations and ongoing collaboration.
• Monitor and analyze market trends, payor policies, and reimbursement rates to identify opportunities for improved financial performance.
• Collaborate with internal stakeholders, including finance, legal, and operational teams, to develop and implement strategies to optimize managed care contracts and payor relationships.
• Provide leadership and guidance to a team of managed care contracting professionals to ensure successful contract negotiations and execution.
• Oversee the development of contract performance metrics and reporting to track progress and identify areas for improvement.
• Serve as a subject matter expert on managed care contracting and payor strategy, providing guidance and support to senior leadership and other stakeholders.
• Stay current on industry trends, regulations, and best practices related to managed care contracting and payor strategy.
• Represent the multi-hospital system in negotiations with payors, industry events, and other relevant forums to promote the organization's interests and objectives.