Health Care Executive Job Opportunities
Updated October 28, 2009

 

 

  • Director, Compliance and Regulatory Affairs
    Columbia, SC
Job Description
 
Position Purpose
Perform duties to direct all aspects of compliance functions of the health plan, negotiate and handle the relationship with the Medicaid agency, the insurance agency in the State and delegate entities, aid in formulating and administering organization policies and procedure and participates in business development opportunities for the company.
 
Position Qualification Requirements
 
Knowledge/Experience
Advanced knowledge of a specialized or technical field such as management, public policy, government affairs. Equivalent to a four (4) year college education. Advanced degree preferred. Over five years up to and including seven years of management experience. Experience in a managed care or insurance environment.
 
Skills/Competencies
Apply principles of logical or scientific thinking to define problems, collect data, establish facts, and draw valid conclusions. Deal with several abstract and concrete variables. Perform advanced functions of mathematics, algebra and statistics. Apply mathematical operations to frequency distributions, reliability and validity of tests, normal curve, analysis of variance, correlation techniques and factor analysis. Perform reading, writing and speaking at an advanced level. Read periodicals, journals, manuals. Prepare business letters, expositions, summaries and reports using prescribed format and conforming to all rules of punctuation, grammar, diction and style. Participate in panel discussions and debates, and speak extemporaneously on a variety of subjects. Ability to use computer systems for the management, reporting and presentation of information, as well as correspondence. Ability to travel.
 
Principal Functions and Accountabilities
 
Leadership
Confer with President and other senior staff to review achievements and discuss required changes in goals or objectives resulting from current status and conditions. Develop, implement and maintain production and quality standards for the health plan.
 
Significant Duties
Research and stay abreast of state and federal regulatory compliance issues and serve as lead of the integration of compliance projects at the health plan level.
 
Needs Analysis and Planning
Evaluates and implements changes to service functions and performance in relation to company mission, philosophy objectives and policies.
 
Strategic Planning
Participate in formulating and administering company policies and developing long-range goals and objectives. In support of the company’s strategic plan, establish the department’s strategic vision, objectives and attendant policies and procedures for the organization. Partner with business unit leaders to identify and prioritize needs of the organization. Evaluate current procedures and practices for accomplishing the organization and department’s objectives to develop and implement improved procedures and practices and to ensure compliance with all related laws, regulations and executive orders.
 
Standardize Applications and Processes
Research and incorporate best practices into operations. Assures that department functions and responsibilities are coordinated with other operating departments of the Plan and Corporate. Responsible for the statistical analysis of utilization data. Participates in NCQA accreditation of the Plan.
 
Budgeting
Monitor and analyze costs and prepare the annual departmental budget
 
Cross-Functional Activities
Chair, participate in, attend, and plan/coordinate, staff, departmental, committee, sub-committee, community, State and other activities, meetings and seminars. Serve on senior executive and management committees, as well as directing special projects or studies.
 
For more information, call David Mara at 804.527.1905. To view additional opportunities, go to www.nexushc.com
 
  • Director Network Development
    Des Moines, IA
    Principal Financial Group
  • Experience with PPO Network providers
  • Strong relationship building skills
  • Contract experience
  • Strategic thinker
Responsibilities
Provide strategic leadership to the im
plementation of medical network, medical provider and medical vendor contracting strategies for assigned region.
 
Qualifications
Bachelor's degree or equivalent plus 8-10 years related work experience required. ICA - International Claim Association (ICA), Fellow, Life Management Institute - LOMA (FLMI), Health Insurance Association of America (HIAA), or Academy for Healthcare Management (AHM) designations preferred. Advanced knowledge of business unit products and basic knowledge of company products required. Must have excellent planning/organizational, problem-solving, analytical, presentation, and oral and written communication skills, as well as advanced math skills. Excellent leadership skills required, along with excellent time management and decision-making skills. Must be able to maintain a high degree of accuracy. Advanced computer skills and knowledge of business unit applications required. Ability to maintain confidentiality essential. Travel required 30% including overnight stays.

For more information, please contact David Mara at 804.527.1905.   For additional opportunities, go to www.nexushc.com

 

Cenpatico Behavioral Health (CBH), a subsidiary of Centene Corporation®, a leading multi-line healthcare enterprise, has experienced phenomenal growth, and as a result we have an opportunity in Austin, Texas for a Manager of Provider Relations & Contracting.
 
In this dynamic role you will implement development activities for the recruitment, contracting and retention of providers, negotiating contracts and developing strategies and methodologies for specific network development initiatives.
 
Qualifications include a Bachelor’s degree or equivalent experience in a related field, Master’s degree preferred; 3-5 years of experience in contracting, network development and/or provider relations with project management and supervisory/lead experience.  Experience in a healthcare or insurance environment, preferably in Medicaid is also required.
 
A career with Centene is an opportunity to make a difference in an environment where you have the support you need to succeed, amazing colleagues, and the benefits of a comprehensive total rewards package. We offer our employees competitive pay with bonus potential, a 401(k) program with matching benefit, tuition reimbursement program and receive paid vacation, sick and personal leave plus 12 paid holidays annually. Join our team and experience the rewards!
 
To find out more about our organization and to apply, visit us online: http://www.centene.com/

Equal Opportunity Employer

 

  • Executive Vice President
P. A. R. Associates, a national executive search firm has a Nashville-based client: PivotHealth, LLC (www.pivothealth.com) that is seeking an Executive Vice President for its new division: the Physician Services Company (PSC). In general, the Executive Vice President of the PSC will work with members of the PivotHealth and client hospitals’ senior management teams to design, market, implement, and manage the Physician Services Company in its effort to provide operational infrastructures for the development of their physician integration strategies. What this means is that this executive will develop and deploy, through his/her organization: PMS, EMR, PEO, Billing and Collections services, medical malpractice insurance (optional), and financial/operational benchmarking processes, and get them implemented in the various (contracted) field locations. Implicitly, s/he will be expected to both identify opportunities for new PSC service offerings as well as other PivotHealth engagement opportunities and to market the core services to expand physician practice participation. Some of the more specific activities include:
  • Planning, organizing, directing, controlling and evaluating the functional areas within the PSC (PMS, EMR, Billing and Collections [via an affiliated/partner billing company] financial benchmarking, medical malpractice insurance (optional), the PEO) and underwriting/supporting the achievement of budgeted objectives and profitability goals.
  • Developing and managing (through his/her organization) marketing and community relations strategies resulting in physician practice growth and retention to reach budgeted targets.
  • Assisting in creating collaborative relationships with strategic provider partnerships.
  • With PivotHealth leadership, joint responsibility for negotiating contracts directly with physician and hospital strategic partners.
  • Directing the efforts of senior staff and department heads to meet objectives and goals, with significant emphasis on effective collaboration between the hospital and physician practice leadership and employees.
  • Developing and executing local strategic business plans to give direction for future growth for all product lines, in situ.
  • Responsible for hiring, developing, training, disciplining and retaining high-quality employees, including an Executive Director responsible for the local PSC in each PSC market.
  • Responsible for maintaining peer relationships with community leaders and industry executives.
  • Developing policy and programs to achieve business results through effective financial management.
The keys to success in this role are based upon a combination of knowledge, experience, motivation and personality. Ideally, the selected candidate will have had several (preferably 15) years of healthcare operations management experience in a large multi-site health system setting and be familiar with the nuances and demands of physician-driven environments. Examples of these might include: multi-specialty group practices, IPAs, MSOs, IDNs, as well as other ambulatory care environments. They will also possess a graduate degree in health, business administration or a related field. The kind of work they will have been most likely doing recently will be: senior vice president of physician integration in a health system, president of a significantly sized MSO, executive director of regional network management where in they will have had responsibilities for: strategic planning (updating mission, vision, and strategies to effectively promote and compete); oversight of revenue cycle management, integrity and efficiency; improving profitability; creation of (benchmark) measurements for productivity, satisfaction, and operational competence for all the providers; familiarity with physician compensation programs sufficient to enhance incentives for productivity; and gifted with the ability to truly provide satisfaction and fulfillment to the various constituencies being served.
 
Over time, this division could become the largest one in the company and its leader would be expected to be a key participant in the over-all direction of the company. As such, it will be important that the selected candidate eventually live in the greater Nashville area.
 
Total compensation will probably aggregate in the mid-$200K area. For more details, including the full Position Description contact Debra Savate, Research Associate at dsavate@gmail.com or phone: (510) 525-0579.

 

  • Director of Contracting
    Atlanta, GA
DeKalb Medical has retained Quick Leonard Kieffer to search for the Director of Contracting. DeKalb Medical (http://www.dekalbmedicalcenter.org/), located in the metro area of Atlanta, is a not-for-profit health care system with 627 beds, and over 3,800 employees.
 
The Director of Contracting will provide managed care expertise, negotiate managed care contracts, monitor contract performance, and collect underpayments. This individual will have responsibility for managed care and contracts currently in place, as well as future contracts secured as a result of an aggressive growth strategy. This individual will manage the people, processes, and associated technology of the entire contracting and payment tracking cycle. The Director will be responsible for the review of all contract terms and rates, as well as analyzing the overall impact to the organization. This role will be very visible and has significant leadership responsibilities within DeKalb Medical.
 
The appropriate candidate for this position will have an educational background in finance as well as extensive, progressive healthcare management experience, with significant preference for those with managed care experience. The Director will also have excellent interpersonal skills and be a hands-on, team player.
 
To nominate potential candidates or request more information, please contact Martha Bermingham or Zack Reynolds at (312) 876-9800, or via e-mail at mbermingham@qlksearch.com or zreynolds@qlksearch.com.