Director, PE&C/ICM Lead
- Nashville, TN
What you'll be doing
- Responsible for providing strategic leadership for provider engagement and contracting for assigned state with a benefit spend of less than $3 billion, or a line of business such as medicaid, or a major enterprise wide initiative, including local cost of care and trend management, provider contracting, implementation. Delivers competitive cost of care trends in assigned state. Develops provider networks that provide a competitive advantage. Aligns contracting strategy with medical management strategy. Integrates quality metrics and incentives into contracting process. Serves as PE&C local single point of accountability for all product lines and is the state lead for the integrated cost management (ICM) committee. Facilitates the implementation of local system and product consolidation efforts. Ensures compliance with regulatory and accreditation standards. Hires, trains, coaches, counsels, and evaluates performance of direct reports.
What your background should be
- 8+ years of experience in healthcare operations, finance, underwriting, actuary, network development and/or sales; or any combination of education and experience, which would provide an equivalent background.
Required Schooling / Training
- Requires BS/BA in business administration or related healthcare field. MBA preferred.
Who is the client company
- This is one of the largest for-profit managed health care companies.
- If you are interested in this position, send your resume to firstname.lastname@example.org