Vice President, Managed Care and Network Development

Shift: Day
Schedule: Full - Time Regular
Ardent Health Services (AHS) is a national healthcare company headquartered in Nashville, TN. Our subsidiaries own and operate hospitals and multispecialty physician practices in six states (New Mexico, Oklahoma, Texas, New Jersey, Kansas, and Idaho). Ardent includes 30 hospitals, 4,840 patient beds, 25,000 employees, 1,150 employed physicians, and has approximately $4.5 billion in net revenue. Within the industry, we are noted for recognizing that every hospital is as unique as the community it serves. This in-depth understanding of how health care works at the local level is one of our great strengths.

The Vice President, Managed Care and Network Development is responsible for managing payer contracts across all Ardent corporate and facility-based service lines, advancing enterprise initiatives and integration, managing payer relationships pertaining to payer contracts, and providing leadership to department staff providing contract support.  The VP will develop Ardent’s network and execute the strategic course for the company in areas such as delivery system, healthcare reform, and strategic pricing approaches for commercial payers.  Additionally, the VP, Managed Care and Network Development will administer, coordinate, and support all commercial contracts with Managed Care Organizations (MCOs) and other commercial payers, contracting, and reporting on behalf of Ardent facilities across all Divisions.  The VP will ensure that all required processes and available strategic pricing, legal, reporting, and processes will maximize contract performance.  This role will be responsible for developing strategies for growing the managed care portfolio.  The VP will also navigate different ways of contracting (i.e. value-based and risk-based) to develop Ardent’s network and ensure delivery of high quality care to patients.  The VP, Managed Care and Network Development will lead key payer negotiations with the goals of growing the managed care portfolio and developing staff negotiation skills.  This position will have significant revenue responsibilities and will require a high level of understanding of healthcare financing and delivery as well as the ability to think strategically and offer innovative solutions to complex challenges.

Examples of Responsibilities:
• Assess and assist in development of key components of CIN to create value for Ardent, physicians, payers, and consumers.
• Overall management of the managed care portfolio.
• Create presentations and deliver updates to senior leadership in a professional manner.
• Build and maintain positive relationships with all Ardent markets.
• Monitor state and federal legislation related to payment initiatives and policy changes that could impact negotiations.
• Assess and review risks and opportunities across the enterprise related to payment reform, value-based purchasing, etc.
• Establish a standard Ardent practice with guidelines, processes (including legal review), and workflows.  Utilize the standard guidelines and processes for negotiation of third party payer contractual agreements, reimbursement rates, etc.
• Oversee negotiation of hospital and physician rates, language, risk assessment, and contractual amendments with market directors and the legal department.
• Ensure annual reviews of provider contracts are completed by market directors.

Key Relationships:
• Work proactively and collaboratively with peers at corporate, specifically those working directly with Revenue Cycle and Government Relations.
• Strong relationships with Divisional leadership across the organization.
• Work closely with Director of Managed Care within each market.  The Directors will have a dotted line reporting structure to the VP, Managed Care and Network Development.
• Positive and collaborative relationships with peers at our Joint Venture partners.
• Work collaboratively with key managed care partners.

• Bachelor's degree, Required
• Master's degree in related field, Preferred

• 10+ years of experience in Managed Care contract negotiation, Required
• Experience in large, multi-facility organization, Required
• Multi-state experience, Preferred
• Previous experience with an insurance provider, Preferred

Behavior Standards:
• Service – Patient Centered Customer Service
• Quality – Clinical and Operational Excellence
• People – Promotes a Collaborative Environment
• Financial – Business Acumen
• Growth – Fosters Innovation