Top Managed Care Executive jobs in Raleigh, NC

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Job Summary:

The System Executive Director – Managed Care position is responsible for planning, directing and coordinating all Managed Care operations. This position establishes and maintains the objectives and strategy for the department in order to effectively contribute to executing the overarching HCS strategic plan. This position directs the development, implementation, and maintenance of system-wide contracting policies and procedures, processes, and measurement tools. The System Executive Director – Managed Care is responsible for the evaluation, measurement, and reporting of the financial and operational performance of managed care contracts, including the establishment of tools to support the managed care contracting process.

Job Responsibilities:

1. Managed Care- Leads the development and implementation of all managed care programs while leveraging UNC Health Care resources. Leads relationship building initiatives and business opportunity assessment with administrative and clinical leadership. Ensures managed care payer compliance. Leads the establishment of managed care payer specific action plans to track and trend issues and provides information to senior management. Monitors managed care volume trends in order to implement appropriate measures to protect and grow net revenue. Collaborates with senior management to develop and implement innovative payer partnerships geared towards capitalizing on a variety of the UNC Health Care's value based strengths. Ensures effective and efficient delivery, communication, and administration of all related programs.

2. Leading Change- Acts as a catalyst for organizational change. Influences others to translate vision into action. Brings about strategic change, both within and outside the organization, to meet organizational goals. Establishes an organizational vision and implements it in a continuously changing environment. Is open to change and new information and rapidly adapts to new information, changing conditions, or unexpected obstacles. Deals effectively with pressure and remains optimistic and persistent, even under adversity. Recovers quickly from setbacks. Formulates objectives and priorities, and implements plans consistent with the long-term interests of the organization. Capitalizes on opportunities and manages risks. Takes a long-term view and builds a shared vision with others.

3. Leading People- Leads people toward meeting the organization's vision, mission, and goals. Provides an inclusive workplace that fosters the development of others, facilitates cooperation and teamwork, and supports constructive resolution of conflicts. Encourages workforce engagement by building a commitment to excellence and by promoting the organization's vision internally and externally. Delegates responsibility, clarifies expectations and holds others accountable for achieving results related to their area of responsibility. Leads in a deliberate and predictable way and operates with transparency. Treats sensitive or confidential information appropriately. Develops the ability of others to perform and contribute to the organization by providing ongoing feedback and by providing opportunities to learn through formal and informal methods. Manages and resolves conflicts and disagreements in a constructive manner.

4. Results Driven- Exceeds organizational goals and customer expectations. Makes decisions that produce high-quality results by applying technical knowledge, analyzing problems, and calculating risks. Holds self and others accountable for measurable high-quality, timely, and cost-effective results. Delivers high-quality services and is committed to continuous improvement. Fosters a culture of safe and compassionate patient care. Makes well-informed, timely decisions, even when data are limited or solutions produce unfavorable results. Positions the organization for success by identifying new opportunities and builds the organization by developing and improving services. Leads the budgeting process. Uses cost-benefit thinking to set priorities, monitors expenditures in support of programs and policies, and identifies cost-effective approaches.

Qualifications: 

Education Requirements:

Bachelor’s degree in an appropriate discipline.

Professional Experience Requirements:

Ten (10) years of experience in managed care, with at least seven years management experience in managed care

Knowledge, Skills, and Abilities Requirements:

Understands and applies principles, procedures, requirements, regulations, and policies related to specialized expertise. •Demonstrates broad understanding of principles including financial planning and analysis, reimbursement, contract negotiations and problem solving. •Maintains knowledge of current trends and developments in the managed care field

Job Details

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: Managed Care

Work Type: Full Time

Standard Hours Per Week: 40.00

Pay offers are determined by experience and internal equity.

Work Assignment Type: Hybrid

Work Schedule: Day Job

Location of Job: US:NC: Morrisville

Exempt From Overtime: Exempt: Yes

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position.

Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.