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Regional Director, Managed Care Contract
Leadership | SSM Health St. Anthony Hospital | Oklahoma City, OK | Req #: 18003046
Description

Role Purpose:

Responsible for leading managed care strategy development and/or implementation, negotiations, management and implementation of the Hospital Organization, Physician Organization, PHO and CIO managed care contracting process for SSM Health OK region.

Responsibilities:
  • Imparts the philosophy, values, mission and vision of SSM Health and facilitates the integration of values in CQI.
  • Understands, embraces and practices the principles of CQI in utilizing the Malcolm Baldrige criteria as a means to achieve performance excellence.
  • Understands, embraces and models the SSM Health leadership competencies and exceptional service standards.
  • Leads and oversees negotiation of managed care payor contracts for SSM/MCO provider entities in the SSM Health OK Region. Fosters good working relationships with managed care plan executives to ensure good communication and results for SSM Health.
  • Leads and attends meetings including but not limited to MCC Regional Managed Care Contracting committees; CIO Board and Payor Relations Committees; MCO Board of Directors; ExclusiveChoice Operations; MCO Staff and other ad hoc as appropriate
  • Implements process improvements with the MCO Operations, Managed Care Contracting Process, and other areas of SSM Health as appropriate.
  • Leads strategic initiatives that affect the managed care contracting process (i.e. new services to be added to contracts or additional provider sites).
  • Responsible for staying up to date on managed care trends and makes recommendations to SSM Health's Managed Care Organization in anticipation of, or in response to, changing managed care environment.

Qualifications

Minimum Qualifications:
  • Graduation from an accredited college or university with a bachelor's degree, preferably with a major in health related field.
  • Eight (8+) years of progressive experience with managed care environment; experience in contract negotiations; work with Commercial, Medicare Advantage, Medicaid HMO, TriCare and Direct to Employer is preferable.
  • Five (5) years of management experience.
  • Experience in managing projects involving the collaboration, motivation and cooperation of a wide variety of people with whom there is no direct reporting relationship.
About SSM St. Anthony Hospital
St. Anthony Hospital is a 601-bed regional referral facility specializing in cardiology, oncology, surgery and behavioral medicine. The hospital, established in 1898, is located in Midtown Oklahoma City and serves the needs of Central Oklahoma, as well as many counties throughout Oklahoma, through its large rural affiliate network of hospitals. Four St. Anthony Healthplex campuses provide convenient emergency and outpatient service access to the outlying communities of the metropolitan area. St. Anthony added urgent care services in May 2015 at St. Anthony North. St. Anthony has received numerous awards including the Oklahoma Quality Award for Excellence, Certified Healthy Business, Premier QUEST® Award for High-value Healthcare Citation of Merit, among others. Healthsights ranks St. Anthony at performance levels for quality and patient satisfaction higher than local competitors and many national health care organizations.
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Hope Valvero
Hope Valvero
Senior Leader of Physician and Provider Recruitment
LinkedIn
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Hope Valvero
Hope Valvero
Senior Leader of Physician and Provider Recruitment
LinkedIn

Why SSM Health

At SSM Health, we are driven by a singular Mission: Through our exceptional health care services, we reveal the healing presence of God. It's a higher calling that binds us. Here, we work together, system and providers alike, to heal the body, mind and spirit of our patients. We are united by a shared commitment to serve through faith, humanity, compassionate care and exceptional medicine.

Employment Benefits

  • Health, dental and vision insurance
  • Malpractice insurance
  • Paid time off
  • Retirement savings plan
  • CME stipends and time
  • Adoption reimbursement
  • And more!

Diversity, Inclusion
and Equality

At SSM Health, diversity, inclusion and equality are integral parts of who we are and a reflection of our Mission and values. We believe that workplace diversity is essential to our success. We seek to foster awareness and appreciation of diversity among our patients, employees, physicians, providers, customers and communities.

We are proud to be an Equal Opportunity and Affirmative Action Employer. Qualified applicants are considered for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity or any other characteristic protected by law.

Quality of Life

Oklahoma

Oklahoma City’s metro area, long known for its western heritage and cattle stockyards, is experiencing an exciting period of revitalization and growth. Today, more businesses and young families are flocking into the city limits and making this area their home. The city is developing into a more cosmopolitan center with diverse dining opportunities, entertainment, museums and sporting events. The city, as well as the surrounding suburbs, are home to tight-knit communities and neighborhoods that are welcoming to new residents and families. With its perfect blend of small town hospitality and metropolitan amenities, Oklahoma City may very well be America’s biggest small town.

Oklahoma City