Director of Managed Care
full-time•Gainesville
About this role
Overview
Responsibilities
Qualifications
The Director, Contracting & Operations is responsible for providing guidance and leadership to the Managed Care Account Management and Population Care Management teams for the Gainesville campus. Responsible for direct oversite of Managers, Analysts, Coordinators, Systems Specialists, and others who may function in an Assistant capacity, including those that manage provider enrollment, websites, case agreements, and newsletter processes.
Responsibilities
- Responsible to interface with other operational areas and build strategic relationships between ones' area and other areas.
- Responsible for managed care contracting, including but not limited to value based and pay for performance contracting, and population health initiatives to position SUFHCN (hospitals, ancillary facilities, and UF and Shands physicians and providers) as a major referral institution for the state of Florida, and as the dominant health care provider within its local service area and surrounding core counties.
- Also responsible for ensuring the operational efficiency of existing contracts. The Director, Contracting & Operations, works with the Assoc. Vice President of Managed Care in determining payor contracting strategies, negotiating contracts, policy development, departmental goals, and planning.
- The Director also prioritizes and directs the workload of staff and initiating and coordinating contract negotiations activity across functional areas (legal, pricing analysis, billing and AR, UF clinics and hospital operations, physicians and other providers, network management and contract management) to ensure contract implementation, execution, and improved contract operational and financial performance.
Qualifications
- Requires a BS or BA degree in business or health care field and 5 to 7 years of experience in managed care industry - whether payor or provider-related, with direct supervisory experience.
- In lieu of a BS or BA degree, the candidate must have an AA degree and 7 to 9 years of experience, or a high school diploma with 9 to 10 years of experience.
- Must have experience with contract review and financial negotiation and knowledge of financial analysis methods (including payor and provider pricing, actuarial risk analysis, and premium development), claims management, utilization review management, benefit plan management, and financial and accounts receivable report management.
- Must have experience in managing projects and work product of other professional-level personnel.
Other facts
Tech stack
Managed Care Contracting,Population Care Management,Contract Negotiation,Value Based Contracting,Pay For Performance Contracting,Operational Efficiency,Policy Development,Workload Prioritization,Financial Analysis,Claims Management,Utilization Review Management,Benefit Plan Management,Provider Enrollment,Strategic Relationship Building,Supervisory Experience,Contract Review
About UF Health
University of Florida Health is a world-class academic health center in Florida, encompassing hospitals, physician practices, colleges, centers, institutes, programs and services across northeast and north-central Florida.
UF Health represents the shared vision and commitment to patient care excellence of more than 22,000 employees of the University of Florida Health Science Center and UF Health Shands health care system.
Team size: 10,001+ employees
Website: http://www.ufhealth.org
LinkedIn: Visit
Industry: Hospitals and Health Care
Founding Year: 1958
What you'll do
- This Director provides guidance and leadership to the Managed Care Account Management and Population Care Management teams, overseeing staff responsible for provider enrollment, case agreements, and newsletter processes. Responsibilities include managing managed care contracting, such as value-based and pay-for-performance agreements, and ensuring the operational efficiency of existing contracts.
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Frequently Asked Questions
What does a Director of Managed Care do at UF Health?
As a Director of Managed Care at UF Health, you will: this Director provides guidance and leadership to the Managed Care Account Management and Population Care Management teams, overseeing staff responsible for provider enrollment, case agreements, and newsletter processes. Responsibilities include managing managed care contracting, such as value-based and pay-for-performance agreements, and ensuring the operational efficiency of existing contracts..
Why join UF Health as a Director of Managed Care?
UF Health is a leading Hospitals and Health Care company.
Is the Director of Managed Care position at UF Health remote?
The Director of Managed Care position at UF Health is based in Gainesville, Florida, United States. Contact the company through Clera for specific work arrangement details.
How do I apply for the Director of Managed Care position at UF Health?
You can apply for the Director of Managed Care position at UF Health directly through Clera. Click the "Apply Now" button above to start your application. Clera's AI-powered platform will help match your profile with this opportunity and guide you through the application process. You can also learn more about UF Health on their website.