Director, Regional Managed Care Operations, Michigan Market (remote based in Detroit area)
Location: Detroit, Michigan
Internal Number: 2205012279
The Director, Regional Managed Care Operations, is responsible for negotiating local/regional Managed Care agreements with applicable health plans such as Blue Cross Blue Shield MI, Priority Health, HAP, McLaren, new MA plan, and medical groups. Developing and maintaining strong relationships with the personnel at the regional/local health plans is very important to Tenetâ��s success. The person in this position is also responsible handling all of the ongoing contract operational aspects of the job in terms of interfacing with hospital CEOs, CFOs, CSOs, and other hospital personnel, as well as regional leadership and home office personnel. The Director also works closely with Conifer personnel, Managed Care Legal and others to secure appropriate payment under our revenue cycle operational activities and leading settlement efforts on old, unpaid claims that need to be closed-out. Finally, the Director is responsible for supporting managed care for CINS and DCEs which market providers participate in.
***Although this is a remote opportunity, you must be available for onsite meetings with the market, and therefore, must reside in the Detroit, MI area. ***
7+ years of Managed Care experience
Bachelorâ��s degree with Masters or other advanced degree preferred
Strong organizational and communication skills
Strong relationships with people in the industry
Tenet Healthcare/USPI complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.
Primary Location: Detroit, Michigan
Facility: 984-Fort Lauderdale, FL
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Tenet Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas with 112,000 employees. Through an expansive care network that includes United Surgical Partners International, we operate 65 hospitals and approximately 510 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers and other care sites and clinics. We also operate Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.