AVP Managed Care

Description

This position is incentive eligible.
Introduction

We are seeking an AVP Managed Care with Surgery Ventures powered by HCA Healthcare to promote growth and unlock possibilities. At HCA Healthcare, we are committed to the care and improvement of human life. Share your leadership skills and come make a difference with us!

Benefits

Surgery Ventures powered by HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  
• Family support through fertility and family building benefits with Progyny and adoption assistance.
  
• Referral services for child, elder and pet care, home and auto repair, event planning and more
  
• Consumer discounts through Abenity and Consumer Discounts
  
• Retirement readiness, rollover assistance services and preferred banking partnerships
  
• Education assistance (tuition, student loan, certification support, dependent scholarships)
  
• Colleague recognition program
  
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

We are seeking an AVP Managed Care for our team to be an innovator. HCA Healthcare partners with Harvard Pilgrim Institute and the CDC to use our data from more than 26 million patient encounters each year to impact the industry. Come build your career with us!

Job Summary and Qualifications

At the direction of the Regional VP of Managed Care Ambulatory Surgery, the CVP of Payer Contracting and Alignment (“PCA”) and on behalf of Surgery Ventures Group powered by HCA Healthcare President: Ensure the effective administration, coordination and support of all Managed Care negotiation, contracting and reporting activities on behalf of the Surgery Ventures Group powered by HCA Healthcare pursuant to the business/financial plan and PCA policies and procedures. The AVP of Managed Care will work with other members of the system-wide Managed Care department to successfully negotiate Managed Care contracts for HCA. The AVP of Managed Care is responsible for coordinating the overall system contracting strategy for HCA. This individual must be able to think strategically, across multi-states, multi-markets, and all healthcare services that HCA offers, in addition to being able to analyze data and manage projects efficiently. Prefer for the AVP of Managed Care to be based in Dallas, Texas, but some flexibility exists to live elsewhere and travel regularly to Dallas, Texas. The AVP of Managed Care will have oversight responsibility for all Managed Care contracting activities for Surgery Ventures Group.

What you will do in this role:

• The primary responsibility of the AVP is to oversee PCA’s optimization of the fee-for-service price/volume equation of a net revenue portfolio greater than $1.0B but no more than $1.5B.
• The AVP will ensure that all required processes and available strategic pricing, legal, reporting and communication tools and processes will be deployed in order to both (a) maximize contract performance/yield (e.g., Net Revenue, Percentage of Charge Revenue, Net Revenue per Case, Contribution Margin, etc.), and (b) be consistent with the ASD’s EBIDTA and pricing bandwidth management objectives. Among these requirements will be maintaining an effective working relationship with the Analytics & Pricing Services (A&PS), PCA negotiators (“PCA VPs”) and PCA Legal department staffs and adeptness with QlikView and other tools.
• The AVP will collaborate and assist with PCA VPs across the enterprise (e.g. PCA-Hospital and Government AVP and RVP colleagues) on contracting activities with Managed Care organizations (“MCOs”) and other payers.
• The AVP will monitor and evaluate upcoming contract renewals by creating and utilizing portfolio performance and renewal monitoring reporting in order to recommend renewal-specific pricing changes, and track whether the recommendations are made by PCA VPs. Collect key pricing requests from Ambulatory Surgery Division Regional VPs and prioritize them for PCA VPs to pursue during MCO negotiations.
• The AVP will work with Ambulatory Surgery Division business office personnel (including RBOMs & RBODs) to identify trended contractual rate, rate structure, or language issues and to ensure Carrier Code to Major Payer mappings are maintained.
• As appropriate, the AVP may partner with MCOs on data-driven collaboration to identify opportunities to offer a savings to the MCO and patients. The AVP may need to create a quality story for PCA VPs to present to MCOs and other payers to educate them on outcomes, cost savings, and value.
• The AVP must understand ASD coding, payment modeling and the revenue cycle to create preferred ASC rate template(s) with grouper methodologies, case rate carve-outs, and implant & high cost drug reimbursement and be able to identify orthopedics/spine-driven ASCs to target for implant reimbursement add-ons. 

What is required for this role: 

HCA Healthcare (Corporate), based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleled resources and opportunities to reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education and career advancement opportunities, every person has a solid foundation for success. Nashville is also home to our Executive Development Program, where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

Join our family of over 180 hospitals and about 2,000 sites of care to drive excellence and raise the bar for our over 35 million annual patient encounters.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.