Director of Managed Care

Job description

- Residing in Nashville or Franklin area, highly preferred. PURPOSE AND SCOPE: Directs organization's activities of strategic planning, evaluation, coordination, and implementation of various managed health care programs (HMOs, PPOs, POS, etc). Oversees Division's contractual relationships with managed care organizations and other third party payors regarding rate structures for services, clinical and financial reporting obligations, establishment of other business terms per the FMCNA Guidelines, contract maintenance such as facility list updates and amendments. Develops and directs regional marketing efforts to third party payors in order to support growth and profitability in the region. PRINCIPAL DUTIES AND RESPONSIBILITIES: Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions. - Manages the tactical execution of short- and long-term objectives through the coordination of activities with a direct responsibility for results, including costs, methods, and staffing. - Reviews and analyzes potential contracts for financial effect, cost benefit and utilization. - Negotiates contrac...