Director Managed Care, Professional Services

  • University Medical Center of Southern Nevada
  • Las Vegas, Nevada
  • Apr 11, 2024
Full Time Administration and Management Public Health
  • Salary: $56.81 - $90.90 Hourly USD

Job Description

Position Summary

EMPLOYER-PAID PENSION PLAN (NEVADA PERS)
COMPETITIVE SALARY & BENEFITS PACKAG
E

This position is considered AT-WILL and will serve at the pleasure of the CEO.

As an academic medical center with a rich history of providing life-saving treatment in Southern Nevada, UMC serves as the anchor hospital of the Las Vegas Medical District, offering Nevada’s highest level of care to promote successful medical outcomes for patients.
We are home to Nevada's ONLY Level I Trauma Center, Designated Pediatric Trauma Center, Burn Care Center, and Transplant Center. We are a Pathway Designated facility by ANCC, and we are on our journey to Magnet status
.

Position Summary:
Performs managed care contracting on behalf of the hospital, review and analyze contract performance and develop in conjunction with the CEO and CFO a managed care strategy.

Job Requirement

Education/Experience:

Equivalent to a Bachelor’s Degree in public or business administration and five (5) years of experience negotiating managed care agreements with commercial payers, Medicare Advantage Payers and Managed Medicaid Payers and five (5) years leading revenue cycle department and/or billing, coding experience.

Additional and/or Preferred Position Requirements

PREFERENCES WILL BE GIVEN TO APPLICANTS WHO DOCUMENT THE FOLLOWING:
  • 10 years or greater experience negotiating managed care agreements using RBRVS reimbursement formulas
  • 10 years or greater experience negotiating managed care agreements with Medicare Advantage Payers and Managed Medicaid Payers
  • 5 years or greater experience leading a Revenue Cycle Department
  • 5 years or greater experience working as a day-to-day billing and coding staff member
  • Strong technical expert with a diverse work experience and long-time established relationships
  • Prefer Certified Professional Coder, Certified Professional Medical Auditor
  • Strong attention to detail
  • Local market experience
  • Strong analytical skills and attention to detail
  • Strong interpersonal skills
  • Billing experience



Knowledge, Skills, Abilities, and Physical Requirements

Knowledge of:
UMC policies and procedures as they apply to Primary and Quick Care Units; managed care terminology; supervisory principles and practices; marketing principles and practices; Federal, state and county laws and regulations related to the health care agency; basic data sampling and statistical analysis techniques; computer applications related to duties; department and hospital safety practice and procedures; patient rights; age specific patient care practices; infection control policies and practices; handling, storage, use and disposal of hazardous materials; department and hospital emergency response policies and procedures.

Skill in:
Carrying assigned project(s) through, from data gathering to completion; using initiative and independent judgement within general policy guidelines; use of computer software/applications related to duties; developing contractual relationships; negotiating contracts for services; maintaining accurate records and files; preparing clear and concise reports, correspondence and other written materials; contributing effectively to the accomplishment of team or work unit goals, objectives and activities; using computers and related software applications; communicating with a wide variety of people from diverse socio-economic and ethnic backgrounds; establishing and maintaining effective working relationships with all personnel contacted in the course of duties; efficient, effective and safe use of equipment.

Physical Requirements and Working Conditions:
Mobility to work in a typical office setting and use standard office equipment, stamina to remain standing for long periods of time, vision to read printed materials and a VDT screen, and hearing and speech to communicate in person and over the telephone. Strength and agility to occasionally lift and carry up to 25 pounds. Attend meeting outside of normal work hours.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification.

Please note: This is an EXEMPT position which is not covered by the union. Applicants for employment to non-union eligible positions are not eligible for longevity benefits. Current UMC employees who have not qualified for longevity payments (do not have 8 full years of creditable service) and who voluntarily transfer, promote, demote or are reassigned into a non-union eligible position will not receive the longevity benefit.

#LI-SS1

The University Medical Center of Southern Nevada offers a comprehensive & competitive benefits package:
  • Employer Paid Pension Plan through Nevada Public Employees' Retirement System "PERS"!https://www.nvpers.org/front
    • Vestingin the pension plan after 5 years of qualifying employment!
  • Health/Dental/Vision Insurance - Less than $10 per paycheck for employee-only coverage
  • Consolidated Annual Leave (CAL) - CAL is used for personal leave, holidays (eleven scheduled holidays per year), doctor appointments, vacation, and sick days up to 16 consecutive scheduled work hours (short-term sick leave), etc.
  • Extended Illness Bank (a/k/a Sick Bank)
  • 457 Deferred Compensation Plan
  • Comprehensive Group Health Insurance Plan
  • Nevada has no State Income Tax
  • No Social Security (FICA) Deduction

As an academic medical center with a rich history of providing life-saving treatment in Southern Nevada, UMC serves as the anchor hospital of the Las Vegas Medical District, offering Nevada’s highest level of care to promote successful medical outcomes for patients.

We are home to Nevada's ONLY Level I Trauma Center, Designated Pediatric Trauma Center, Burn Care Center, and Transplant Center. We are a Pathway Designated facility by ANCC, and we are on our journey to Magnet status.

THE UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA IS AN AFFIRMATIVE ACTION/ EQUAL OPPORTUNITY EMPLOYER

Closing Date/Time: Continuous

Job Address

Las Vegas, Nevada United States View Map