Analysis Skills, Budget Management, Communication Skills, Community Providers, Contract Negotiation, Correctional Health, Data Analysis, Dental Insurance, Employee Assistance Plan, Employee Benefits, Facebook, Forecasting, Health Plan, Healthcare, Healthcare Providers, Hospital, Leadership, LinkedIn, Managed Care, Market Trend Analysis, Medicaid, Medicare, Medicare Reimbursement, Mentoring, Negotiation Skills, Network Monitoring, Network Performance/Analysis, Operational Strategy, Organizational Skills, Product Programs, Provider Contracting, Reimbursement, Request for Proposals (RFP), Standards of Care, Team Lead/Manager, Team Player, Vision Plan, Willing to Travel
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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Naphcare, Inc.
NaphCare is dedicated to implementing cost-effective, quality services according to our clients' needs.
Because every facility is unique, we tailor our services to meet each client's respective needs. We deliver solutions based on your requests rather than telling you how to run your facility. NaphCare evaluates, evolves, and adapts our programs according to not only client needs, but also the ever-changing field of correctional healthcare.
When you choose NaphCare, you choose a proactive, preventive healthcare provider. We focus on a “Day One” mentality, providing care up front and without delay. Our clients experience greater efficiency, a reduction in unnecessary costs, and transfer their legal liability, all without giving up their independence. NaphCare is leading the way with an all-in-one approach to correctional healthcare that provides services unique to your facility.
Personal Attention
With NaphCare, people come first. We are proud of our company culture and ability to connect with our clients on a personal level, and it is NaphCare's mission to continue our history of personalized service. Care is not reserved simply for the patients entrusted to us, but also for our client partners. We care for our clients by providing efficient services to reduce their costs, communicating regularly about our services, listening to the client, providing accountability through continuous quality studies and reporting, and working with integrity at all times.
Company Consistency
Also, as an independent healthcare partner, we are free from complex partnerships and distant investors that limit our competitors' responsiveness. NaphCare has not undergone any corporate reorganization or restructuring since the company was founded in 1989, and has no plans to do so in the future. This stability, along with planned and structured growth, ensures that our client partners receive personal attention from our administrative and medical support team at our headquarters.
Financial Stability
NaphCare is a financially stable and fiscally responsible company. Throughout our history, we have maintained steady, measured growth, more stable than sweeping corporate changes. Our clients do not have to worry about drastic shifts in our company and how such changes will affect their services.
One of the best indicators of a company's financial stability is its ability to secure insurance and a bonding line. NaphCare is proud of our ability to provide performance bonds, rather than letters of credit. Due to our financial strength, NaphCare has exceptional insurance programs that indemnify our clients against litigation regarding healthcare services.