Directs the following day to day managed care, contract performance, and value based contracting activities throughout the entire Summa Health System including applicable Summa Health System hospitals, employed physicians, all applicable Summa Health Network (SHN) provider clients and the New. Health Collaborative providers. Organizes, directs and controls the accounting, financial reporting, budget and general monitoring of SHN and NHC financial activities. Directly oversees the financial analy... more details
System Director, Managed Care/Finance
Summa Health System is recognized as one of the region’s top employers by a number of third party organizations, including NorthCoast 99. Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and competitive pay and benefits.
Summary: Directs the following day to day managed care, contract performance, and value based contracting activities throughout the entire Summa Health System including applicable Summa Health System hospitals, employed physicians, all applicable Summa Health Network (SHN) provider clients and the NewHealth Collaborative providers. Organizes, directs and controls the accounting, financial reporting, budget and general monitoring of SHN and NHC financial activities. Directly oversees the financial analysis specific to each managed care and value based contracts. Develops and presents strategic recommendations based on pertinent financial and market data to the managed care and population health strategic work group. Ensures negotiation of new contracts or re-negotiation of existing contracts and subsequent System wide implementation of the managed care and value based contracts.
Formal Education: a. Bachelor’s Degree Required b. Graduate level work or Master’s Degree in finance, or Certified Public Account certification preferred
Experience & Training Required: a. Ten (10) years’ experience in healthcare environment that has provided knowledge of healthcare reimbursement, financial analysis specific to third party payer relationships and contract negotiations b. Two (2) years’ experience in value based contract incentive programs.
Other Skills, Competencies and Qualifications: a. Working knowledge base of each unique business entity within the Summa Health System b. Excellent verbal and written communication skills c. Ability to professionally represent Summa Health System and its services to payors and managed care programs d. Current knowledge of managed care delivery systems and hospital operations e. Ability to maintain confidentiality of patient and other proprietary information f. Ability to facilitate negotiations and payor relationships toward understanding customer’s needs and maintaining client satisfaction g. Ability to understand and communicate recognized trends and potential changes within the managed care market h. Ability to understand and interpret financial statements i. Assumes accountability for demonstrating behaviors consistent with the customer service policy j. Population Specific Competency: ability to effectively interact with patients/customers with the understanding of their needs for self-respect and dignity k. Knowledge of value based contract components, reporting, and quality metrics.
Level of Physical Demands: a. Sedentary: Exerts up to ten pounds of force occasionally and/or a negligible amount of force frequently
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$79.38/hr - $119.07/hr
The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.
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