Senior Advisor, Healthcare Contract Negotiation

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities.

Job Description Summary:

The Senior Advisor, Healthcare Contract Negotiation is responsible for directing Managed Care operations and administrative management for managed care contracting, contractual performance and compliance processes, enforcement and operational processes associated with administering the managed care contracting activities of the OhioHealth system, Clinically Integrated Network, and its affiliated entities. This includes advanced contract document drafting skills and/or experience and ability to draft sophisticated contract language to execute on managed care strategies.

Key responsibilities include, but are not limited to: analyzing and conducting payer negotiations, maintaining key payer relationships, as well as serving as the point of contact and presence for communications with internal customers, as well as commercial and governmental MCO’s. In consultation with the Vice President of Managed Care and Senior Director of Managed Care, the incumbent will help develop and implement OhioHealth’s managed care and population health strategy for facility and ancillary services, OhioHealth Physician Group Enterprise, and the OhioHealth Clinically Integrated Network. They play an important role in serving in a leadership capacity to monitor managed care market trends, payer policy changes, and managed care insurance and regulatory industry changes in the Commercial, Medicare Advantage and Managed Medicaid MCO environment. They are also responsible for providing managed care strategic and operational support to various business units and system entities for new business ventures, acquisitions and strategies. In addition, the Senior Advisor assists with development and implementation of value based programs in consultation with the OhioHealth Clinically Integrated Network in support of Population Health strategies and goals. They will also maintain and grow payer relationships on behalf the OhioHealth system and the CIN.

MINIMUM QUALIFICATIONS
Bachelor's Degree
Years of experience: 5 to 7 progressively challenging managed care experience in healthcare provider or payer setting

SPECIALIZED KNOWLEDGE
Understanding of managed care insurance products and their financial impacts on payers and providers.
Experience with managed care negotiation and contracting processes
Understanding of provider financial and revenue cycle issues
Demonstrated skills with variety of standard computer applications
Superior organization and communications skills.

LOCATION:
Blom Administrative Campus
3430 OhioHealth Parkway
Columbus, OH 43202

Minimum Qualifications:

Bachelor's Degree (Required)