Essential Functions

• Responsible for leading and directing Managed Care activities on behalf of all Orlando Health facilities  and affiliated/owned ancillary providers in accordance with corporate market share, financial, and community-focused goals and objectives.
• This entails a market and financial analysis, legal contract review, contract language and rate negotiations/re-negotiations, contract implementation and maintenance, health plan delegated credentialing, and ongoing support of the client relationship.
• Establishes and maintains a strong, open and positive working relationship with external Managed Care plan executives and team members, employers, physicians, Orlando Health executives and team members, patients/customers, and the Orlando community.
• Works with newly acquired facility and ancillary providers to facilitate integration of Managed Care contracts.
• Responsible for the selection and retention of staff who meet high standards of performance as well as possessing exceptional team and standards of behavior.
• Mentors and encourages professional development of team members.
• Develops and implements operational plans consistent with the overall corporate goals and objectives. Establishes a system for variance control.
• Provides input, recommendations, and actively participates in development of corporate strategic plans and Managed Care contracting decisions.
• Establishes Critical Success Factors for Managed Care contracting, in conjunction with corporate Critical Success Factors.
• Consistently monitors and takes corrective action to ensure standards are met or exceeded.
• Participates with management, medical staff, and clinical areas in Orlando Health's decision making structure and process.
• Functions as a resource to Orlando Health management and physician community by providing timely and accurate Managed Care Orlando market and contract information to assist in the full accomplishment of their goals and objectives.
• Maintains, revises, and implements changes in policies and procedures to meet all licensing agency requirements, such as Joint Commission, local, state, and federal regulatory agencies.
• Develops and monitors budget and takes corrective, as necessary, to resolve variances.
• Keeps abreast of current issues and trends in the Managed Care environment on the local, state, and national levels.
• Supports all established policies, procedures, goals and objectives of Orlando Health.

Other Related Functions

• Participates in Managed Care associations to keep abreast of current issues and trendsaffecting Managed Care.
• Provides for personal and professional growth.
• Performs all other duties as assigned.

Education/Training

• Bachelor's Degree required. Masters preferred.
• Licensure/Certification
• Current driver’s license.

Experience

• Seven (7) years’ experience in Managed Care contract negotiations and operations.
• Three (3) years’ experience in management and supervision of staff

Essential Technical/Motor Skills

• Ability to make a movement response accurately and quickly.

Essential Mental Abilities

• Knowledgeable and competent to perform all essential functions.

Essential Sensory Requirements

• Ability to visually and audibly perform all essential functions.

Essential Physical Requirements

• Sufficient mobility and strength to move within the facility, as well as various environments external to the facility. Requires access to vehicle at all times during normal business hours.
• Requires extensive local travel.