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Director Long Term Care & Home Base Care Services Contracting Job

Full Job Title: Director Long Term Care & Home Base Care Services Contracting

Job Number: 1705635

Location: Tampa, FL

Date Posted: 11-28-2017

Identifies prospects, negotiates and manages contractual relationships with practitioners, facilities and vendors that provide institutional and home based care services to members enrolled in long term care managed care programs; effectively and professionally representing the enterprise to the provider community and other external stakeholders.

Reports to: VP, Network Performance
Dept.: CNS-Enterprise Network Performance
Location: Tampa, FL

Essential Functions:

  • Develops, negotiates and manages provider contracts for a set of long term care services and provider types including but not limited to: long term and post-acute nursing facilities, assisted living, independent living Geriatric Support/Long Term Care Service Coordination, adult day care, adult foster care, group adult foster care & group homes, homemaker/personal care services, meals, respite care and all other community based services
  • Ensures that all contracts meet market financial budgetary targets, as well as all legal and regulatory requirements.
  • Maintains solid understanding of Medicare and Medicaid reimbursement methodologies, competitive landscape for LTC/LTSS relative to network partnerships, payment models and network innovations.
  • Ensures network adequacy for all required services including adherence with all state and federal regulatory requirements.
  • Conducts on-going assessments of assigned provider network types and puts forth recommendations for strategic improvements.
  • Supports RPF process as necessary to ensure timely, successful bid submissions.
  • Leads and/or participates in cross-functional meetings and projects related to assigned provider types and serve as the company-wide subject matter expert on long term and home based care providers and related services.
Additional Responsibilities:Candidate Education:
  • Required A Bachelor's Degree in a related field
  • Preferred A Master's Degree in a related field
Candidate Experience:
  • Required 7 years of experience in the healthcare sector (preferably at HMO or PPO)
  • Required 5 years of experience in Long term and home based contracting and vendor relations experience
  • Required 4 years of experience in in leadership position(s)
Candidate Skills:
  • Intermediate Demonstrated interpersonal/verbal communication skills
  • Intermediate Demonstrated written communication skills
  • Advanced Demonstrated customer service skills
  • Advanced Demonstrated analytical skills
  • Advanced Demonstrated negotiation skills
  • Advanced Demonstrated organizational skills
  • Advanced Ability to influence internal and external constituents
  • Advanced Other Demonstrated negotiation and contract development skills with long term and home based care providers and vendors
  • Advanced Other Ability to work in a self-directed manner environment and manage competing and changing priorities
  • Intermediate Other Knowledge of regulatory requirements concerning Medicare and Medicaid
  • Advanced Other Ability to identify unusual variation in costs and to assess impact of change
  • Intermediate Other Ability to identify unusual variation in costs and to assess impact of change Ability to remain calm under pressure

Technical Skills:

  • Required Intermediate Microsoft Visio
  • Required Intermediate Microsoft Excel
  • Required Intermediate Microsoft Outlook
  • Required Intermediate Microsoft PowerPoint

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    Last Updated On: 12/9/2015