Chief Managed Care Officer

Responsibilities

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World’s Most Admired Companies by Fortune; listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

UHS seeks to hire a Chief Managed Care Officer (CMCO) to support the Acute and Behavioral Health (BH) Divisions. This person is the senior executive responsible for the organization's overall managed care strategy, operations, and financial performance. This role involves developing and maintaining relationships with health insurance providers (payers), negotiating contracts, and ensuring that care delivery is both high-quality and cost-effective. The CMCO has a dual reporting structure to the President of the Acute Division and the President of the Behavioral Health Division.

This opportunity offers the following:

Competitive Compensation & Generous Paid Time Off

Excellent Medical, Dental, Vision and Prescription Drug Plans

401(K) with company match and discounted stock plan

SoFi Student Loan Refinancing Program

Career development opportunities within UHS and its 300+ Subsidiaries!

More information is available on our Benefits Guest Website: benefits.uhsguest.com

Key Responsibilities

The duties of a CMCO are broad and cross-functional, involving collaboration with financial, clinical, and administrative teams.

• Strategic Leadership & Contracting: In conjunction with the Acute and BH Divisions, develop and implement a comprehensive managed care contracting strategy, serving as the chief negotiator for all contracts with commercial, government and non-government payers. This includes negotiating reimbursement rates for all levels of care, leading payer remediation and workout efforts, implementing value-based payment models and driving medical/behavioral integration payment models.
• Financial & Operational Oversight: Monitor and analyze contract performance and financial data to identify cost-saving opportunities and areas for improvement. They ensure financial sustainability and operational efficiency within managed care functions. This role utilizes published payor and competitive rates as well as Trilliant data to ensure best in class reimbursement.
• Provider Network Management: Oversee the development and maintenance of strong relationships with in-network and out-of-network providers. This includes ensuring adequate network capacity and facilitating provider enrollment processes.
• Regulatory Compliance and Advocacy: Ensure all managed care operations and contracts comply with federal, state, and local regulations and accreditation standards (e.g., HIPAA, ACA, CMS guidelines). Additionally, partner with trade associations to include NABH, The Federation, AHA, AHIP, etc. to advocate for provider reimbursement and BH rate parity.
• Quality and Process Improvement: Collaborate with clinical leadership (like the Chief Medical Officer and Chief Nursing Officer) to develop models of care that improve patient outcomes, enhance patient satisfaction, and ensure appropriate utilization of resources.
• Market Analysis & Business Development: Continuously monitor the competitive landscape and industry trends, using insights to inform organizational strategy and identify new growth opportunities and partnerships.
• Leadership Development: Create organizational structure for the managed care department. Hire regional managed care experts and provide direction to attain optimal reimbursement rates from payors.
• Travel to UHS facilities on a regular basis.

Qualifications

Successful candidates typically possess a blend of extensive experience and strong leadership abilities.

• Education: A Bachelor's degree in healthcare administration, business administration, or a related field is required, with a Master's degree (MHA, MBA, or MPH) strongly preferred.
• Experience: Extensive experience (10-15 years) in a managed care leadership role within a healthcare system or health plan is essential, with a proven track record of successful contract negotiations and strategic initiative implementation.
• Skills: Key skills include strong negotiation, analytical, and problem-solving abilities, along with excellent communication and leadership skills to influence stakeholders and lead cross-functional teams effectively.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.