Director, Managed Care

Company Summary

If you are searching for a fulfilling place to develop your career and an opportunity to make a difference in helping others, then keep reading on. Here at AAC, we have a progressive culture; we listen to your ideas, value a work/life balance, invest in education, and we foster trust and respect for all individuals. Our exceptional comp and strong benefits include company matching 401K, medical, dental, vision and life insurance. We are looking for our future leaders, who are not only going to fill the qualifications for this job description, but who are going to exceed expectations. Be a part of a team whose mission is to provide quality, compassionate, and innovative care to adults struggling with addiction and co-occurring mental health disorders. Our purpose and passion are to empower patients, their families, and our communities by helping individuals achieve recovery and optimal wellness of the mind, body, and spirit.

Job Summary

The Director of Managed Care is responsible for all duties related to managing payor relationships, contract negotiations, financial modeling and tracking of new and existing national and regional payor contract.  Possesses the necessary negotiations skills to establish national-level agreements with Payor Executives.

Duties and Responsibilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Lead, develop and implement strategic relationships with major payors on a regional and/or national level.
• Support the development and contracting for value-based population health opportunities and new reimbursement models.
• Identify revenue opportunities with existing and prospective payor agreements. Maintain contract renewal schedule to ensure timely review and renegotiation of contracts.
• With the help of FP&A, manage financial modeling specific to contracting efforts, ensuring negotiated rates meet desired objectives.
• Provide reports and analysis of performance, providing recommendations and feedback for contract renewals, renegotiations, or termination.
• Experienced with negotiating national-level contracts with Payor Executives. Possesses an understanding of Payor operations.
• Responsible for the oversight of the strategic development, coordination, and analysis of managed care agreements (Commercial, Medicare, and Medicaid).
• Responsible for the development and management of the annual contracting budget.
• Partner with leaders within Revenue Cycle, Business Development, Facilities, Operations, Finance, and Compliance regarding contracting, financial and strategic objectives.
• Working with FP&A and IT, develop reports and reporting solutions specific to payor relations, managed care and contracting needs.
• Monitor the financial and operational performance and trends of payor contracts and report to Executive Team.
• Performs other related duties and special projects as assigned.

Education/ Experience:

• Bachelor’s degree in Business Administration, Health Care Administration, or equivalent/related field. (Master’s preferred)
• In-depth contracting experience and someone who is very process oriented
• 7+ years of related experience negotiating hospital, large physician groups and ancillary services agreements and external customer service for providers
• Experience in marketing/sales/finance in a managed care or insurance environment
• Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff

Physical Requirements

AAC is committed to principles of equal opportunities for all employees.  The Company will provide reasonable accommodations that are necessary to comply with State and Federal disability discrimination laws.

• Prolonged sitting at a desk
• Must be able to lift 15 pounds at a time

Supervisory Responsibility

• Responsible for leading and coaching a team
• Oversees the daily workflow of the department
• Provides constructive and timely performance evaluations

Other Work Requirements:

• Expected Hours of work: Full-time, Monday-Friday, 40 hours per week

American Addiction Centers is an equal opportunity employer.  American Addiction Centers prohibits employment practices that discriminate against individuals or groups of employees based on age, color disability, national origin, race, religion, sex, sexual orientation, pregnancy, veteran or military status, genetic information or any other category deemed protected by state and/or federal law.