Vice President of Managed Care jobs in United States
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University Health KC · 1 day ago

Vice President of Managed Care

University Health KC is a healthcare organization seeking a Vice President of Managed Care who will be a key member of the executive leadership team. This role is responsible for driving managed care strategy, operations, and performance improvement to ensure financial sustainability and quality patient access through effective contract negotiations and payer engagement.

Health CareHospitalMedicalRehabilitation

Responsibilities

Develop and implement innovative short- and long-term strategies to optimize managed care operations and financial performance
Oversee budgeting, staffing, and resource allocation for the Managed Care department
Analyze financial and utilization data to identify inefficiencies and drive process improvements
Ensure strategies align with the hospital’s mission, vision, and business objectives
Lead high-impact contract negotiations with managed care organizations to secure favorable terms
Identify and evaluate new payer opportunities, including Medicaid expansion and exchange plans
Partner with legal, actuarial, and consulting experts to support data-informed negotiation and risk assessment
Ensure strong contractual language that enforces accountability, compliance, and revenue protection
Oversee auditing, performance monitoring, and compliance of managed care contracts
Direct reporting and analysis to identify underpayments, discrepancies, and revenue recovery opportunities
Evaluate reimbursement models and payment terms for continuous improvement
Resolve disputes with payers and ensure adherence to federal, state, and internal compliance standards
Recruit, develop, and manage Managed Care staff, ensuring high performance and accountability
Conduct regular performance reviews, team meetings, and professional development planning
Ensure all licensures, certifications, and registries are current and properly verified
Collaborate with executive and clinical leaders to align managed care strategy with organizational and clinical goals
Work with physicians, administrators, and external partners to optimize managed care performance
Support initiatives tied to 340B programs, value-based care, and payer collaboration
Partner with leadership to develop robust information systems that support contract management and analytics
Oversee system upgrades and vendor relationships to ensure accuracy, compliance, and efficiency
Maintain expert-level knowledge of managed care regulations and ensure compliance with all applicable laws and standards
Model organizational values by promoting quality improvement, patient safety, and cultural diversity
Uphold the Code of Conduct and actively participate in compliance and training initiatives

Qualification

Managed care expertiseContract negotiationsFinancial analysisRegulatory knowledgeLeadership experienceCompliance knowledgeInterpersonal skillsCommunication skillsProblem-solving skillsTeam management

Required

Master's degree in a healthcare-related field
7–10 years of progressively responsible experience in managed care administration
In-depth knowledge of managed care industry dynamics, including regulatory, actuarial, and competitive factors
Strong financial, analytical, and problem-solving skills
Excellent negotiation, interpersonal, and communication abilities
Demonstrated success in leadership roles across complex healthcare organizations
Ability to travel locally and occasionally overnight

Preferred

Leadership-specific training or certification

Company

University Health KC

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University Health (UH) has all the things you expect from a great health system.

Funding

Current Stage
Late Stage
Total Funding
$1M
Key Investors
McCombs Enterprises
2023-06-01Grant· $1M

Leadership Team

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Harold Siglar
Chief Executive Officer
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Rob Jones
Chief Technology Officer
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Company data provided by crunchbase