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Directs organization's activities of strategic planning, evaluation, coordination, and implementation of various managed health care programs (HMO's, PPO's, long-term care). Organizes and develops short- and long-term planning programs to ascertain community and organization's requirements. Typically reports to Hospital Administrator and directs subordinate staff.: Administers fiscal operations such as budget planning and establishing rates for alternative delivery services. Directs activities concerned with contracts for alternate delivery systems. Reviews bids for conformity to contract requirements and determines acceptable bids. Negotiates contract with bidder. Requests or approves amendments to or extensions of contracts. Develops policies and procedures for various activities to assure objectives of hospital, managed care, physicians, care givers and patients are met. Ensures compliance of facilities with all regulations. Ensures that all providers and employees meet and maintain requirements and licenses. Develops and implements methods and procedures for monitoring work activities, such as preparation of records of expenditures, progress reports, etc., in order to inform management of current status of work activities. Recommends measures to improve methods, performance, and quality of service, and suggests changes in working conditions to increase efficiency. May recruit, hire, train staff, evaluate employee performance, and recommend or initiate promotions, transfers, and disciplinary action. Analyzes department budget to identify budget needs and or reductions, and may allocate operating budget's funds. Interprets company policy to employees and enforces safety regulations.

Managed Care Director

Develops and implements strategic, operational, and tactical business plans to meet customer service requirements and optimize financial performance. Maintains and develops relationships with health plans and medical groups. Develops contracting plans and forecasts. : Directs and performs the negotiation of contracts with managed care payers and group purchasing organizations. Monitors existing contract performance. Conducts financial analyses and considers impact of applicable regulatory requirements. Collaborates with senior management and/or multiple decision-makers to conclude sales. Serves as liaison between customer and company personnel on administrative matters. Develops and assists in implementation of referral strategies. Develops and manages the budget. Controls expenses while meeting operational, financial, and service requirements. Recruits, develops, and motivates staff. May lead team of sales/technical/marketing personnel on larger sales efforts.

Top Managed Care Executive

Managed Care Contracting Manager

Responsible for the coordination, evaluation and negotiation of managed care contracts under consideration. This position typically requires five or more years of experience in the negotiation of contracts in a managed care or hospital environment.: Responsible for the coordination, evaluation and negotiation of managed care contracts under consideration. Responsible for the oversight of all contract coordination activities. Represents the organization to the employer community and solicits business. Works with current subscribers to develop additional business opportunities. Coordinates contract negotiation and resolves complex issues. Works closely with physicians in program development and specialist relations. Monitors managed care contract performance and addresses related concerns. Evaluates potential business opportunities and develops innovative approaches that can benefit the organization. Attempts to standardize contracts to ensure effective and efficient implementation. This position typically requires five or more years of experience in the negotiation of contracts in a managed care or hospital environment.

Regional Vice President

Directs and coordinates activities and overall management of the operations of a region of an organization. Participates in formulating and administering regional policies and developing long-range goals and objectives. Reviews analyses of activities, costs, operations, and forecasts data to determine region progress toward stated goals and objectives. Manages financial performance, budgets, productivity, utilization, staff relations, quality control, customer satisfaction, and adherence to policies and procedures and professional standards as established by company.: Ensures regional profitability by overseeing the development and maintenance of regional budgets. Oversees and trains the Regional or Area Directors and/or Managers regarding all areas of organization's financial management. Participates in annual budgeting and forecasting for region. Recommends management staffing positions for the operations within the region. Recommends overall staffing levels for the operations within the region. Provides guidance and direction to Directors and Managers in the areas of goal setting and objectives. Guides and directs the development and implementation of quality assurance, training, and development. Responsible for compliance and delivery of required products or services in adherence with organization, Federal, State, and local regulations. Communicates and interacts with facility personnel to ensure continued satisfaction in department performance.

Supervisor Managed Care

Supervises and coordinates the activities of personnel in the managed care department of a healthcare facility to ensure department productivity and quality goals are met. Assists with the analysis of the financial and operational impact of managed care contracts and the maintenance of related databases within the overall structure developed by the Director of Managed Care. Participates in and provides oversight of contract compliance activities and maintains relationships with key health plan contacts. Serves as a liaison to Finance Department regarding managed care related issues.: Hires, schedules, and monitors staff in the Managed Care Department. Ensures employees receive appropriate orientation and training to perform their jobs, including writing and communicating standard operating procedures. Tracks employee time and attendance. Provides financial data to management as well as other reporting concerning daily operations within the department. Tracks, communicates, and compares key terms and conditions and reviews the language of all managed care contracts to ensure terms and conditions meet the standards established by the Managed Care Department. Manages multiple projects within required timelines. Performs data entry, maintenance, and reporting for database of all active contracts as well as other hospital information systems. Supports negotiations by providing reports or other contract comparison tools. Negotiates with health plans on a case by case basis for services not covered under contract.

Analyst Organization

Analyzes organizational structure, responsibilities, teamwork, capabilities of incumbents, business or operating procedures, reporting relationships, processes, and work flow to devise most efficient methods of accomplishing work. Plans study of work problems and internal disconnects and procedures, such as organizational change, communications, quality control, information flow, integrated production methods, inventory control, or cost analysis. Gathers and organizes information on problem or processes including present operating processes. : Analyzes data gathered, develops information, and considers all available solutions or alternate methods of proceeding. Organizes and documents findings of studies and prepares recommendations for implementation of new systems, procedures, or organizational changes. Confers with personnel concerned to assure smooth functioning of newly implemented systems or procedures. May also participate in manpower planning and succession planning. May install new systems and train personnel in application and team building. May conduct operational effectiveness reviews to ensure functional or project systems are applied as designed and functioning satisfactorily. May develop or update functional or operating manuals outlining established methods of performing work in accordance with organizational policy.

Sales Regional Manager

Manages the promotion and direction of the sales or service activities among customers or prospects in a region. Reviews market analyses to determine customer needs, volume potential, price schedules, and discount rates, and develops sales campaigns. Typically reports to a National Sales Manager and has supervisors and/or subordinate sales staff who call on existing or potential customers reporting to this position.: Ensures that representatives keep informed of changes in territories that might affect product sales. Holds sales meetings. Makes forecasts on anticipated market sales. Analyzes sales statistics to formulate policy and assist in promoting sales. Studies schedules and estimates time, cost, and labor estimates for completion of job assignments. Develops and implements methods and procedures for monitoring work activities, such as preparation of records of expenditures, progress reports, etc., in order to inform management of current status or sales activities. Represents company at industry association meetings and trade shows to promote product. Acts as liaison between sales and other departments. Participates in budget preparation. Assists other departments within establishment to prepare manuals and technical publications. Prepares periodic sales reports showing sales volumes and potential sales. Interprets company policy to ensure company objectives are met. Directs product simplification and standardization to eliminate unprofitable items from sales line. Promotes satisfactory customer relations. Works closely with company personnel to ensure prompt service to customers. Keeps informed on company contract procedures and product pricing. May direct staffing and training to develop sales program.

Executive Director Not for Profit Organization

Plans, develops, and establishes policies and objectives of organization in accordance with board directives and corporation charter. This is the top executive and principal organization leader in the organization. Title practices among companies vary; depending on the organization, the position may have the title of Chairman of the Board & Chief Executive Officer, Chief Executive Officer, Chief Executive Officer & President, President, General Manager, or other combinations. This position is distinguished from others in that it is the top ranking executive and, in most cases, is the highest paid executive in the organization. Reports to Board of Directors and often is a member of the board.: Responsible for the profitability of the entire organization. Confers with organization officials to plan business objectives, to develop organizational policies to coordinate functions and operations between divisions and departments, and to establish responsibilities and procedures for attaining objectives. Reviews activity reports and financial statements to determine progress and status in attaining objectives and revises objectives and plans in accordance with current conditions. Directs and coordinates formulation of financial programs to provide funding for new or continuing operations to maximize returns on investments, and to increase productivity. Plans and develops industrial, labor, and public relations policies designed to improve company's image and relations with customers, employees, stockholders, and public. Evaluates performance of executives for compliance with established policies and objectives of firm and contributions in attaining objectives. May preside over Board of Directors. May serve as chairman of committees, such as management, executive, engineering, and sales.

Regional Executive Director Health Plans

Directs the overall operation and provides executive leadership in a regional health plan.: This is the top regional executive and a principal organization leader in the health plan. Responsible for the profitability of the regional organization. Establishes strategic plans and guides implementation. Confers with executive management to plan operational objectives, to develop policies and procedures, to coordinate functions and operations between divisions, departments and satellite locations, and to establish responsibilities and procedures for attaining objectives. Reviews activity reports and financial statements to determine progress and status in attaining objectives and revises objectives and plans in accordance with current conditions. Directs and coordinates formulation of financial programs to provide funding for new or continuing operations and guides changes needed to reach financial goals. Represents the organization to major external authorities and constituencies. Plans and develops labor, and public relations policies designed to improve the organization's image and relations with patients, providers, employees, and the general public. Selects and evaluates performance of executive staff for compliance with established policies. An advanced degree in a field of health or business is typically required for this position.

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