Ssm Health Looking for Director-Managed Care Analytics at St Louis, Missouri Full Time

PRIMARY RESPONSIBILITIES

• Oversees utilization and financial reports used for contract payment, performance and improvements. Develops and tests pricing models with contracted payers that maximize net operating margins and ensure market competitiveness.
• Oversees all updates, changes, compliance and regulatory functions as they relate to managed care contracts.
• Serves as network contact for managed care contracting functions. Provides resolution to managed care contractual issues pertaining to contract interpretation and coding with payers.
• Assesses managed care contracting requirements and standards as they relate to industry/regulatory issues and market implications. Recommends and implements necessary improvements and revisions to contracting requirements and standards.
• Evaluates and recommends financial parameters and reimbursement methodologies.
• Responsible for management functions including activities related to staffing such as recruitment, hiring, performance evaluation, and compensation determination.
• Performs other duties as assigned.

EDUCATION

• Master’s Degree

EXPERIENCE

• Ten years’ experience, with five years in leadership

PHYSICAL REQUIREMENTS

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, kneeling, squatting, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.

SSM Health is a nationally recognized Catholic, not-for-profit integrated health system serving Illinois, Missouri, Oklahoma, and Wisconsin.

To request additional information, confidentially submit your interest, or nominate a fellow colleague, please contact:

Jon Dirksen

Executive Talent Acquisition

(see below)

Director-Managed Care Analytics

Directs reporting and analysis of financial performance for managed care contracts.