Director of Managed Care - SMS-2853
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Springfield, IL 62702
Under the direct supervision of the Chief Financial Officer; the Director of Managed Care is responsible for providing strategic leadership, financial and administrative oversight of Managed Care contracting with commercial payers on behalf of SIU Medicine, working closely with departmental staff and clinic physicians to develop a portfolio of participating network contracts and enhance revenue and patient access. The Director will also be responsible for oversight and the providing of strategic leadership to the Credentialing Department and will assist with developing credentialing policies and procedures when needed. Responsible for providing on-going analysis of SIU Medicine’s risk-based insurance products held in joint venture with partner organizations. The Director will also provide oversight of all property-casualty risk inducting lability, worker’s compensation, claims and loss control, Director and Officers’ liability, and cyber liability.
- Degree in Healthcare Administration or Business Administration required.
- Extensive knowledge and experience with health insurance claim data and/or Managed Care payment methodologies.
- Knowledge of Federal and State regulatory environment related to Managed Care.
- At least 5 years of previous Supervisory experience in Managed Care Department.
- Previous 7-10 years experience with and negotiating Managed Care contracts with payers.
- Sensitive to the needs of underrepresented minority populations
Health, vision, dental and life insurance offered on Day 1 of employment
13 paid holidays per year
Choice of retirement plans
Generous vacation time
Tuition Reimbursement and Tuition Waivers
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Certain requirements may apply for out-of-state applicants. Please visit https://siumed.edu/hr and review the specific job listing information for details.
Southern Illinois University School of Medicine is an Equal Opportunity Employer.