Fairview Health Services Director, Finance - Managed Care in Minneapolis, Minnesota

Overview

The Director of Managed Care has accountability for effective and timely execution of all managed care contract negotiations and settlements for hospital, physician and continuum of services provided by Fairview and various affiliated partners. Is accountable for achieving budgeted net revenue expectations for all managed care contracts; assesses, evaluates and directs the application of contracting principles, data analysis, contract language review and contract performance reporting. Responsible for payer relationship management and the development of payor and partner strategies. Continuously builds upon Fairview's knowledge of how health care is transacted to ensure the financial and operational objectives of Fairview and its partners are achieved.

Responsibilities/Job Description

  • Develop, recommend and implement Fairview managed care payor strategy

  • Expert knowledge of provider contracting and negotiations, network development and configuration, standards for managed care delivery and cost containment programs.

  • Assess/recommend Fairview participation in new/existing managed care products to optimize revenue mix

  • Ability to act and think creatively. Ability to gain support and influence decision makers at all levels

  • Develop, recommend annual managed care negotiation parameters and execute negotiations consistent with budget

  • Strong financial analysis and modeling skills. Proven negotiation/mediation experience.

  • Support market scenario planning and analysis

  • Substantive knowledge of managed care policy and direction.

  • Assure efficient and effective communication and implementation of Fairview's managed care contract relationships.

  • Strong written and verbal communication skills. Strong interpersonal and teamwork skills.

  • Oversees financial, operational and delivery aspects of payer contracts

  • Excellent analytical, communication and customer service skills.

  • Maintain positive working relationships with all of Fairview’s managed care payer relationships.

  • Strong customer relations skills.

  • Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.

Qualifications

Required

Education:

  • Bachelor’s degree

Experience:

  • 8-10 years of healthcare experience in managed care negotiating and contracting for integrated delivery systems.

  • Proven business, motivational, customer service, relationship, and negotiating skills.

  • 5 - 7 years management experience.

Preferred

Education:

  • Master’s degree

Experience:

  • Lean process improvement. Experience in a large matrixed organization.

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Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Joined by HealthEast in June 2017, Fairview is one of the most comprehensive and geographically accessible systems in the state, with 12 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area and north-central Minnesota.

Its broad continuum also includes 56 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.

EEO/AA Employer/Vet/DisabledAll qualified applicants will receive consideration without regard to any lawfully protected status.

Requisition ID 2018-24603

Profession Non-Clinical Professional

Speciality Leadership/Management/Executive

Location Fairview offices at 400 Stinson

Shift day

Hours per 2 weeks 80

Department Revenue Management