What are the responsibilities and job description for the Vice President of Managed Care position at RHC Group Management LLC?
Revere Medical is a primary care provider organization delivering high-quality care to underserved communities across multiple states. Our mission is to ensure that healthcare remains local and improves the lives of people in the communities in which they live and work. Revere Medical is focused on providing exceptional care and improving the clinic experience for providers, clinic teams, and patients.
Our Vice President of Managed care will be located in Massachusetts and manage our Value Based Experience along with the following:
Operating Responsibilities
- Negotiates reimbursement rates, legal terms, performance programs, and risk arrangements with managed care plans on behalf of Revere Medical
- Prepares financial and risk analysis to support senior leadership
- Creates and communicates financial and VBC terms with internal and external leadership including ELT and physician leaders
- Works with analytics team to designs models for the purpose of understanding the historical and future performance of new risk contracts
- Works closely with the Revere operations teams and physician groups to identify systemic issues (e.g., claims underpayments, denials) and develops resolutions that can be addressed in the contract negotiations
- Monitors, interprets and reports on changes in performance, market trends, health care delivery systems and legislative initiatives which impact managed care efforts (e.g., CMS ACO regs, Massachusetts Health Policy Commission)
- Provides support for the key Revere leadership meetings including: the Revere Board Meetings and Revere MBRs
Specialized Knowledge and Skills
1. Strategic Leadership & Vision
- Ability to develop long-term strategies for the organization’s managed care operations.
- Visionary leadership to drive organizational growth, efficiency, and healthcare delivery.
- Understanding of market trends, healthcare reforms, and regulatory changes to shape the future direction.
2. Healthcare Industry Knowledge
- Deep understanding of managed care models (HMO, PPO, ACO, etc.), healthcare regulations, policies, and reimbursement mechanisms.
- Familiarity with CMS (Centers for Medicare & Medicaid Services) guidelines, payer/provider relations, and industry best practices.
- Knowledge of healthcare reform laws, like the Affordable Care Act (ACA).
3. Financial Acumen
- Ability to manage budgets, optimize cost structures, and ensure financial health for the managed care division.
Education
- Bachelors' Degree required. Masters in health care administration, BA or related area strongly preferred.
Benefits Offered: Medical coverage (with discounts for using services through Revere), Dental, Vision, HSA with company contribution, Retirement plans, Life and Disability Insurance and much more!
About Revere Medical:
At Revere Medical we promise to provide care you can trust, outcomes you deserve, and a future you can count on. We are guided by our steadfast commitment to improving patient outcomes by empowering providers to deliver exceptional care needed to forge stronger, healthier communities. We are the leader in delivering patient-centered, provider led services that improve patient outcomes and strengthen communities.
Revere Medical does not discriminate in employment opportunities or practices on the basis of race, color, religion, gender, national origin, age, physical or mental disability, pregnancy, childbirth or related medical conditions, military service obligations, citizenship, sexual orientation, genetic information, or any other characteristic protected by applicable local, state, or federal law.
