Vice President, Managed Care - Managed Care Operations

JOB SUMMARY:

Reporting to the Senior Vice President/Chief Financial Officer, working closely with Vice President and Chief Financial Officer of the Medical Practice Foundation and other members of Senior/Executive Leadership team, the Vice President of Managed Care Contracting will lead the development and implementation of the managed care contracting strategy for the Health System and is responsible for negotiating, implementing, and monitoring of hospital payer contractual agreements.

This position involves frequent interactions with the payers/health plans, community partners, senior leadership of Rady Children's Hospital, Rady Children's Specialists of San Diego (RCSSD), Children's Primary Care Medical Group (CPCMG), and Children's Physicians Medical Group (CPMG), and Rady Children's Board of Directors. Oversees negotiation of all managed care contracts including FFS and capitation arrangements for all Health System Entities while developing contract negotiation strategies that balance alignment with Rady Children's strategic priorities and business objectives to ensure optimal levels of financial reimbursement, maintaining the strength and stability of Rady Children's Health Network and supporting value-based payment methodologies in alignment with System strategic goals.

MINIMUM QUALIFICATIONS:

Bachelor's Degree

5 Years of Experience

5 years of experience in fee for service and capitated managed care contract review and a detailed understanding of the California managed care regulations/requirements.

PREFERRED QUALIFICATIONS:

Master's Degree or Juris Doctor

10+ years of experience in fee for service and capitated managed care contract review and a detailed understanding of the California managed care regulations/requirements.

The current salary range for this position is $100.90 to $146.32

Rady Children’s Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the “date posted” until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.