Director of Managed Care, Colorado Community Health Network
General Statement: The Colorado Community Health Network (CCHN) is a membership association of Community Health Centers (CHCs) serving low-income, homeless, and migrant populations in Colorado. CCHN is a busy, team-oriented non-profit that provides support and technical assistance to CHCs. The Director of Managed Care must be a seasoned professional with expertise in Colorado’s insurance market and familiarity with the development and operation of managed care and provider contracting entities.
The Director of Managed Care reports to the Chief Policy Officer (CPO) and is responsible for a variety of activities that support the organization. Responsibilities include, but are not limited to, developing and vetting Medicaid, Exchange and other insurance contracting opportunities for Colorado CHCs, and working with the Chief Executive Officer and CPO on strategic partnerships and planning for the organization.
- Provide strategic direction to the organization’s work in Medicaid, Exchange and other insurance contracting.
- Vet and/or develop opportunities for Colorado CHCs to have a governance or ownership stake in entities controlling Medicaid dollars/care and with insurance companies serving CHC patients.
- Oversee the CCHN MC Committee, with direction from the CPO and Chief Executive Officer (CEO).
- Develop and sustain external partnerships, including but not limited to:
- Colorado insurers
- Safety net partners
- Department of Health Care Policy and Financing
- Other partners TBD as directed by the CPO or CEO
- Participate actively in the CCHN Chief/Directors Team. Lead and/or serve on other CCHN teams as appropriate.
- Provide high quality customer service and hospitality to CHC members, partners and the general public.
- In partnership with other directors assume other responsibilities as assigned by the CPO and CEO.
- Master’s Degree in appropriate field or undergraduate degree with extensive experience in a relevant field.
- At least five years of experience in a managed care entity or independent provider association development and operations.
- Expertise on Colorado’s insurance market and familiarity with insurers.
- Experience developing and negotiating provider/managed care contracts.
- Ability to work with minimal supervision and maximum accountability.
- Experience in policy development managerial decision-making.
- Excellent computer skills, particularly with all software in Microsoft Office, including Word, Excel, Access, and Outlook. Experience with the Internet and conducting Internet searches.
- Demonstrated ability to work with customer/client groups and/or experience in membership organizations.
- Ability to work as a team member and work effectively with diverse people.
- Demonstrated awareness of, and value for, cultural competence.
- Experience supervising multiple staff, making managerial decisions, and writing grants.
- Fluency in written and spoken English.
- Ability to travel.
- Physical ability to stoop, kneel, bend, use a computer and perform light lifting.
- Expertise working in a non-profit environment and with CHCs is desirable, but not required.
CCHN is a membership organization that places a high value on member relations and hospitality. The successful Director of Managed Care will be responsive to and respectful of member needs, display sound judgment; relate well to the public and staff; have a professional demeanor; prioritize customer satisfaction; have exceptional written and verbal communication skills, and be well organized.
CCHN is an equal opportunity employer, offering flexible benefits, a casual work environment, and a competitive compensation (DOE).
Category: Full-Time; Exempt
Responsible to: Chief Policy Officer
Salary Range: DOE
Job Description Effective Date: March 26, 2013
To apply for this position:
To Apply: Please submit the following to be considered:
- A cover letter,
- Updated resume with all relevant qualifications/history,
- Salary history/requirements,
- Written answers to the following two questions:
- Please describe your experience with any/all of the following: 1) negotiating contracts between insurers and a health care provider or providers, 2) managed care entities, 3) independent practice associations, 4) health care provider payment structures or methodologies, and 5) Colorado’s health care and health insurance marketplace.
- What are the biggest opportunities and threats facing the health care safety net with the implementation in 2014 of the new health insurance Exchange marketplace and the expansion of Medicaid to 134% of the federal poverty level?
Candidates should email the required information to:
NO PHONE CALLS
Posted: April 5, 2013
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