CASY-MSCCN Jobs

Description The Regional Vice President (RVP), Payer Contracting is the managed care leader at the Division level for Providence responsible for a payer portfolio of managed services across Commercial, Exchange, Medicare Advantage and Medicaid product lines. The RVP works collaboratively in partnership with system and Division leadership to develop and execute Providence contracting strategies. The RVP serves as the Chief Contracting Officer for the Division working directly with the Chief Executives, Chief Financial Officers and Chief Strategy and Population Health Officers for the division. This position reports directly to the Chief Contracting Officer with a matrix relationship to the designated leaders in the division. The RVP serves on a team that works together to design and implement strategies for growing the managed care portfolio through price and volume. Manages key payer negotiations and develops partnership strategies with the goal of growing the payer portfolio and advancing payment models to expand value-based reimbursement. The RVP has a team of Directors, Senior Contract Managers and Contract Managers responsible for managing the contracts for all revenue associated with national and regional payers, including but not limited to payers such as United, Aetna, Cigna, Anthem, BlueShield, Healthnet, Kaiser and MediCal plans. This includes managing product development, contract execution, and revenue generated for Commercial, Medicare Advantage, Medicaid, and Accountable Care or Value Based Initiatives. This position is responsible for negotiating with national, regional, and local payers for commercial, government, and growth opportunities and is also responsible for negotiating the various fee structures within each payer contract, including but not limited to, traditional fee-for-service arrangements, capitated arrangements, attributed risk arrangements, quality bonuses and shared or full risk terms for accountable lives. The position is responsible for developing and maintaining strong relationships between the payers and the providers within our system and those providers affiliated with Providence. The position will work closely with our various ACO structures, physician groups, regional healthcare systems, and management structures to achieve the financial goals and strategic priorities identified by the system on an annual basis. The position will work closely with senior leadership at the System and division levels, and with senior leaders in the Contracting Department, Population Health Division, and Operational Units of the Regional Delivery System and local ministries, including Clinical Programs, Finance, Revenue Cycle and Reimbursement to translate contract terms into clear actions that will allow us to perform from a financial, clinical, and operational standpoint. The RVP must be able to balance the needs of the region, the system, and providers across the continuum without losing sight of our mission and core values as an organization. ESSENTIAL FUNCTIONS The Regional Vice President, Payer Contracting will: Provide internal and external strategic direction for Providence while developing aligned relationships between the system and division leadership. In partnership with the division leadership, develop the long-term payer (i.e. managed care) strategy for the Division and leads the implementation of that plan. Represent Providence to the payer community and division leadership in proposing and promoting new financial arrangements that advance the strategic vision of managing a population of lives. Direct all third-party contract renewals and manages negotiation activities in alignment with the Region and/or System objectives. Lead the negotiation team and facilitates the implementation of national and regional contracts in the region. Develop and maintain strong relationships and partnerships with key payers to advance Providen