Position Overview

Plans and directs all aspects of an organization's managed care function. The VP Managed Care is responsible for developing, negotiating, and managing managed care contracts and relationships to optimize reimbursement, ensure compliance, and support the organization's strategic objectives within the insurance sector.  Seeking a professional with current or recent experience in the California managed care market.

Key Responsibilities

• Responsible for directing and implementing managed care systems for healthcare facilities. 
• Lead the negotiation and administration of managed care contracts with payors and providers.
• Develop and implement strategies to maximize reimbursement and minimize financial risk. 
• Monitor contract performance and ensure compliance with regulatory requirements. 
• Collaborate with executive leadership to align managed care initiatives with organizational goals. 
• Analyze market trends and payor performance to inform decision making. 
• Establish and maintain strong relationships with external partners and stakeholders.

Competencies/Skills

• Operational Policy Development
• Managed Care Management 
• Strong negotiation and contract management skills 
• In-depth knowledge of managed care and insurance regulations 
• Strategic planning and analytical abilities 
• Excellent leadership and team management skills 
• Effective communication and interpersonal skills 
• Financial acumen and budget management

Experience

• Minimum of 10 years of experience in managed care, insurance, or healthcare administration, with at least 5 years in a leadership or executive role. 
• Bachelor’s Degree or equivalent experience.