Director of Managed Care Contracting

 
Position: Director of Managed Care Contracting

Job ID: 151374

Location: US-TX-Houston

Department: REVENUE CYCLE ADMINISTRATION

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8am-5pm

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.   Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.   To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.  

Summary:

We are searching for a Director of Managed Care Contracting— someone who works well in a fast-paced setting. In this position, you will be responsible for the development and maintenance of all third-party payer contracts for the Integrated Delivery System to include the organization and the Physician Service Organization. You will ensure the appropriate oversight and development is provided to all of the contracting staff. You must have experience with Managed Care contracts on the hospital side to be successful in this role.

 

Think you’ve got what it takes?



Responsibilities :

  • Provide development and supervision of managers and staff and participate in interdepartmental groups to represent managed care contracting needs including claims, medical management, operations, finance quality improvement and or other related services
  • Give oversight and analysis of managed care contracting services and evaluations of program offerings, health trends, and pricing strategies
  • Interface with internal and external staff to resolve contract performance issues and complaints promptly
  • Develop approaches, policies, and programs for contracting strategies based on goals and objectives, and which meet the business & TCPSO performance goals
  • Support the delivery of cost-effective, community-based and culturally sensitive health care through the development of educational and collaboration opportunities with payers


Qualifications:

  • Bachelor’s degree in business, health care administration, or public health
  • A minimum of 7 years’ of healthcare experience, including three (3) years of managed care experience in a managed care organization and two (2) years of supervisory experience


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