Senior Managed Care Contracting Consultant

Role Overview

• Provides managerial direction, leadership, consultation project management and specialized expertise in the delivery of large, complex and highly visible major payer contracting project initiatives and negotiations.
• Provides strategic leadership in negotiating arrangements with HMO, PPO and other major payer contracting entities in the areas of price negotiations, settlements, project management and evaluation of financial performance, among others.
• Executes managed care strategies developed jointly with Regional Health Ministries (RHM) and System Office leadership.
• Provides a leadership advisory role in problem solving, responding to challenges and potential risk factors and assists in identifying, understanding and utilizing process improvement methodologies.
• Establishes strategies and goals for colleagues, manages resources within budget targets, coordinating allocation of staff resources assigned to achieve optimal outcomes.
• Directs the processes and guidelines around the configuration and maintenance of applicable Analytic Platforms.
• Provides guidance to senior leaders regarding systems and processes for which they are responsible.
• Develops and implements strategies that incorporate business needs and requirements, industry trends and technology solutions which facilitates the achievement of strategic and financial objectives.
• Oversees or directs the integration of vendor tasks and vendor deliverables.
• Maintains a working knowledge of applicable Federal, state and local laws and regulations, Trinity Health's Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

Requirements

• Bachelor’s degree in Public Health, Business Administration, Finance, Accounting, Economics, Informatics or related field.
• Seven (7) to ten (10) years of progressively responsible operational (management), project management or consulting experience in managed care analytics, medical economics reporting, product development or population health analytics or an equivalent combination of education and work experience.
• Significant experience and proven results regarding complex project management or consulting experience in managed care analytics, medical economics reporting, and product development or population health analytics.
• Significant experience gained from health plan, health system, the healthcare industry or a provider health network is required.
• Demonstrated ability to lead and manage with frequent changes in departmental priorities.
• Proven track record of effectively managing progressively large complex projects, which include the management of vendor relationships and multiple technology and analytic solutions to achieve a single business objective with proven successful delivery results.
• Excellent program leadership, organization, integration and execution skills and abilities.
• Proven customer-service orientation.
• Strong interpersonal and relationship building skills with proven ability to initiate and develop productive collaborative partnerships with executive leaders, management, associates, and customers, along with effective vendor interface/management experience.
• Excellent oral and written communication, negotiation and presentation skills.
• Working knowledge of project management, change management, process improvement methodologies, and/or executive coaching.
• Ability to operate in an ambiguous and highly matrix organizational structure.
• Ability to operate in a highly autonomous self-directed manner under frequently changing structures and requirements and work priorities.
• Must possess a personal presence that is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of Trinity Health.