AVP, Managed Care Contracting, Jackson Health System, Full Time

Department: Jackson Memorial Hospital - Managed Care Contracting

Address: 1611 NW 12th Ave, Miami, Florida, 33136

Shift details: Full-Time

Why Jackson:

Jackson Health System is a nationally and internationally recognized academic medical system offering world-class care to any person who walks through our doors. For more than 100 years, Jackson has evolved into one of the world's top medical providers for all levels of care, no matter if it's for a routine patient visit or for a lifesaving procedure. With more than 2,000 licensed beds, we are also proud of our role as the primary teaching hospital for the University of Miami Miller School of Medicine.

Here, the best people come together to deliver Jackson's mission for our diverse communities. Our employees are committed to providing the best CARE by demonstrating compassion, accountability, respect, and expertise in everything we do.

Summary

The Associate Vice President of Managed Care Contracting plays a critical role in the financial success of Jackson Health System by leading the development and execution of managed care contracting strategies. This position is responsible for:

• Negotiating and managing contracts with a wide range of payers
• Ensuring optimal reimbursement rates
• Maximizing revenue generation.

Responsibilities

Contract Negotiation and Management:

• Leads the development and implementation of innovative managed care contracting strategies.
• Negotiates and manages contracts with commercial payers, Medicare Advantage plans, Medicaid managed care organizations, and other payers.
• Analyzes contract performance, identifies areas for improvement, and proactively renegotiates terms to optimize financial outcomes.
• Ensures meticulous compliance with all contractual obligations and regulatory requirements.

Financial Analysis and Modeling:

• Develops and maintains sophisticated financial models to evaluate the impact of managed care contracts on organizational revenue and profitability.
• Conducts comprehensive financial analyses to support contract negotiations and strategic decision-making.
• Monitors and analyzes key performance indicators (KPIs) related to managed care reimbursement and utilization trends.

Relationship Management:

• Builds and maintains strong, collaborative relationships with key stakeholders, including managed care executives, physicians, hospital administrators, and other internal and external partners.
• Effectively represents Jackson Health System at managed care industry events and conferences.
• Collaborates closely with internal departments to ensure alignment between managed care strategies and overall organizational goals.

Leadership and Team Management:

• Provides inspirational leadership and strategic direction to the managed care team.
• Mentors and develops staff members, fostering a culture of collaboration, high performance, and professional growth.

Regulatory Compliance:

• Stays abreast of industry trends, regulatory changes, and healthcare reform initiatives.
• Ensures unwavering compliance with all applicable federal and state regulations related to managed care contracting.

Performs other related job duties as assigned. Job duties listed here are generic in nature and may vary in specifics, as it relates to area of responsibility.

Experience

Generally requires 7 to 10 years of related experience. Leadership experience is required.

Education

• Bachelor's degree in healthcare administration, business administration or related field is required.
• Master's degree is preferred.
A degree in nursing is strongly preferred.

Credentials

Valid license or certification is required as needed, based on the job or specialty.

Jackson Health System is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other status protected by law.