Director, Managed Care

Job description

Position Summary: The Director, Managed Care is responsible for managed care contracting with health plans and related activities for The Guthrie Clinic under the direction of the Vice President, Managed Care. The position is located at The Guthrie Clinic corporate offices in Sayre, PA. Education, License & Cert: Bachelor’s degree required, masters preferred in health care administration or related field required Experience: A minimum of five (5) years of managed care contracting for a health system and/or health plan health plan, with experience in reimbursement analysis in either a provider or health plan . Essential Functions: 1. Manage assigned portfolio of health plan contracts and relationships for all Guthrie hospitals, medical group, and ancillary providers. Lead responsibility for negotiating smaller ‐ mid range non risk contracts ($0‐2 million net revenues) as assigned, providing support as directed for all other risk and non‐risk managed care contracts under the direction of Vice President, Managed Care, including negotiation of rates, payment methodologies, contract language, value based and shared /full risk payment programs. Also following all internal controls for co...