Area Vice President - Payor Contracting
Aurora Health Care
Major Responsibilities:
Develops and manages a portfolio of payer contracts that optimize enterprise organization revenue, margin and growth in alignment with mission and strategic objectives.Establishes and maintains positive, appropriate relationships with market payers. Utilizes communication and organizational skills to work collaboratively and credibly with payers to achieve common objectives and assist in the resolution process related to any disputes.Works collaboratively with internal stakeholders across all business units to define and achieve common payer strategy and reimbursement objectives.Develops and executes communication plans to internal and external stakeholders related to payer relationships, negotiations, organizational contractual obligations, and developments in the managed care marketplace.Works with the Vice President of Revenue Analytics to ensure financial analysis of payer contract performance and modeling projections based on alternate contract agreements with payers, adverse trends, etc., and then makes appropriate recommendations or conclusions for the enterprise.Performs high level review and monitors financial aspects of existing managed care contracts. Utilizes the financial analysis of reimbursement rates from Revenue Analytics for feedback on contract renewals, renegotiations or termination. Makes recommendations regarding participation or non-participation with new or existing agreements and provide feedback to entire Aurora senior leadership regarding financial and/or operational issues with payers.Works with Legal to ensure consistency and to the extent possible, standardization of contract terms.Develops and manages the risk sharing and reconciliation process to manage financial guarantees related to payer and employers.Interfaces with government relations related to any conflicting issues regarding Medicaid management with the State.Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations, and overall employee morale.Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives.Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business.
Licensure, Registration, and/or Certification Required:
Education Required:
Experience Required:
Knowledge, Skills & Abilities Required:
Physical Requirements and Working Conditions:
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
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