Satellite Healthcare

Director Managed Care Services

3+ months agoSan Jose, CA

This position is responsible for driving "provider side" managed care activities including developing relationships with payer and provider entities, growing revenue through contracts, designing, negotiating and closing contracts for Satellite.
Director Managed Care Services - Remote

About Satellite Healthcare

Satellite Healthcare is more than simply a dialysis company. Since our founding in 1974, we have become the industry's leader in personalized quality care: 70% of our centers earn 4- and 5-star ratings from Medicaid and Medicare.gov, far ahead of all other providers. Our success in caring for patients can be attributed to our mission, our not-for-profit structure, and our people. Together, they create a powerfully patient-centered organization.

Our mission is clear: to make life better for people living with kidney disease. Because we are a non-profit, we can pursue that mission with all our resources, united by our passion for patient care. As part of our commitment to continuous improvement, Satellite Research explores new ways to elevate the effectiveness and delivery of dialysis therapy. And Satellite Wellbound is leading the industry in home dialysis because better outcomes and quality of life are our highest priority. We are also substantial contributors to community and philanthropic kidney initiatives.

Across our organization, we share a single mission - to make life better for those living with kidney disease. Watch our video to learn more about our mission.

About the Role

This position is responsible for driving "provider side" managed care activities including developing relationships with payer and provider entities, growing revenue through contracts, designing, negotiating and closing contracts for Satellite. Additionally, the Director, Managed Care-Payer Contracting will have oversight of payer contracts portfolio, providing solutions in physician, payer and patient services, managed care staff and programs. The Director is responsible for serving internal and external customers, physicians and patient needs.

Essential Functions:

Execution

  • Develop, initiate and lead contract negotiations with all payers with input and guidance from Executive Management
  • Maintain strong relationships with all payers, hospital systems, and/or medical groups through meetings, teleconferences and correspondence
  • Manage existing contracts and ensure timely renegotiation that includes contract language changes via amendments, and/or rate changes
  • Responsible for interpretation, implementation and communication of newly executed contracts, both internally and externally
  • Act as primary liaison for payer-related matters for both internal and external clients
  • Work closely with the Accounts Receivable Team to ensure proper implementation of contract terms, transition and addition of centers, and address operational issues
  • Meet with the center's Medical Directors to gain insight on market intelligence while identifying facility and physician contracting opportunities
  • Manage/participate in special projects as assigned by the Executive Management Team

Analysis/Monitoring
  • Develop and utilize management reporting mechanisms tracking the status of all contracting projects and yields
  • Prepare and coordinate financial and utilization analysis to develop recommendations for payer contracting strategy and execution
  • Maintain and distribute a payer contract status report showing the status of all payer contracts, including the effective revenue yield per treatment
  • Work with the Finance Team to prepare and coordinate financial and utilization analysis to develop recommendations for payer contracting strategy and execution

Planning
  • Must be proactive in seeking contracts in new markets to ensure timely patient admissions in new markets
  • Plan and manage the lifecycle of payer contracting arrangements
  • Keeping abreast of industry trends and identifying payer contracting opportunities


Education & Experience:
  • Bachelor's degree or equivalent experience; Master's degree preferred
  • Ten (10) years of experience in leading contract negotiations with HMOs and commercial payers

Knowledge, Skills & Abilities:
  • Solid understanding of provider health care reimbursement methodologies and payer contracting strategies including, but not limited to, fee for services, pay for performance, capitated full risk, and shared risk in Medicare, Medicaid and Commercial lines of business. Experience with dialysis providers and payment methodologies strongly preferred.
  • Strong comprehension of managed care contract language.
  • Strong aptitude for negotiations.
  • Ability to multi-task, superb attention to detail, strong organizational skill, ability to work with minimal supervision
  • Ability to problem-solve and exercise good judgment in a changing environment. Ability to adapt to changes in work environment, work assignments, and/or changes in priorities.
  • Must possess strong leadership and credibility to garner internal resources and support to accomplish results
  • Proficiency with all Microsoft applications
  • Financial and analytical skills
  • Excellent communication and presentation skills
  • Ability to develop relationships with both internal and external stakeholders
  • Occasional travel may be required for meetings with health plans, joint venture partners and internal stakeholders.

About You

Making life better for those with kidney disease is a mission you can embrace fully and passionately. You want to learn about your patients beyond just their time in treatment. You know the value of compassion, commitment and especially collaboration. You believe in continuous improvement as a way of looking at everything. You pursue goals with determination and build long and productive professional relationships.

What You Will Gain

Relationships: You will work directly with a multi-disciplinary team who are just as passionate as you about making a difference in others' lives. You will also work alongside leaders who believe leading means serving; they support you in providing care that is unsurpassed in our industry.

Impact: The care you provide will enable our patients to live a better life that meets their needs holistically.

Growth: A Satellite career offers a lot of challenges, but also the support and leadership to learn and grow from each one. Here, the paths you find for fulfilling your aspirations don't need to be linear if that's your choice. With everything Satellite is doing to be a force for progress in the industry, you have many options before you.

Satellite Healthcare, Inc. is an equal opportunity employer. Satellite Healthcare, Inc . does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.

Satellite Healthcare, Inc . offers a drug free work environment.

Job ID: satellite-1947