Job Information
HCA Healthcare AVP Managed Government Programs in Richmond, Virginia
Description
This position is incentive eligible.
Introduction
Do you want to join an organization that invests in you as an AVP Managed Government Programs? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.
Benefits
HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)
Note: Eligibility for benefits may vary by location.
You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated AVP Managed Government Program like you to be a part of our team.
Job Summary and Qualifications
The AVP of Managed Government Programs will participate in supporting the strategic course for assigned markets to promote maintenance and optimization of the fee-for-service price/volume equation, including seeking opportunities for alternative payment models (APMs) in order to maintain and grow managed government net revenues. In this role you will administer, coordinate and support all negotiation, contracting and reporting activities relative to managed government programs on behalf of the HCA facilities in the markets comprising the AVP’s assigned responsibility portfolio, pursuant to the division or market business/financial plan and PC&A policies and procedures. This is a senior level position within the Company, with significant revenue responsibilities and requiring a high-level understanding of healthcare financing and delivery and the ability to think strategically and offer innovative solutions to the complex challenges facing both the Company specifically and the healthcare industry in general (in addition to the ability to successfully manage day-to-day operational responsibilities).
This role is located onsite in Richmond, Virginia and will have responsibility for the following states: Indiana, New Hampshire, Virginia, Kentucky and South Carolina.
What you will do in this role:
Obtain and maintain contracts with Managed Government Program payers, optimizing the fee-for-service price/volume equation of a net revenue portfolio greater than $.5B but no more than $2.5B, and which includes hospitals, behavioral health facilities, provider-based (free-standing) emergency departments, ambulatory surgery centers and various ancillary provider types, including maintaining connectivity with the Company’s employed physicians (PSG) and other referral alignment vehicles under APMs.
Maintain current knowledge of State and Federal regulations, laws and legislative agendas regarding the healthcare industry, paying particular attention to those involving state Medicaid and managed care, CMS federal programs for FFS Medicare and Medicare Advantage, as well as healthcare reform. Engage and coordinate with HCA’s internal government relations team and state hospital associations to monitor regulatory and legislative changes, and provide formal guidance on risks and opportunities that may impact the managed government portfolio.
Oversee the successful coordination, negotiation and implementation of contracts with Managed Care Organizations (MCOs) operating in the managed government space and maintain effective working relationships with your MCO counterparts.
Ensure that all required processes and available strategic pricing, legal, reporting and communication tools will be deployed in order to both (a) maximize contract performance/yield (e.g., Net Revenue, NRAA, Net Revenue relative to traditional Medicare/Medicaid reimbursement, Contribution Margin, etc.), and (b) be consistent with the Division’s contribution margin and/or EBIDTA and pricing objectives. Among these requirements will be maintaining an effective working relationship with the Analytics & Pricing Services (A&PS) and PC&A Legal department staffs and adeptness with Qlikview, Cash Reconciliation Reports and Service Line tools.
Collaborate and assist with Commercial PC&A and PC&A-Physician Services Group (PSG) colleagues relative to contracting activities with MCOs and other payers.
Monitor Managed Government Program payers’ performance via regular reviews of payer volume, rate and yield, including volume/yield and cash reconciliation reporting on at least a quarterly basis. You will also be heavily involved in denial management activities, from avoidance (by securing robust contract protections) to information gathering (via regular meetings with Case Management and SSCs and participation in DMAT) to resolution (via JOCs and other problem-solving interfacing with the MCOs) to disputes (via involvement with PC&A Legal, SSC Legal, external counsel and other dispute resolution processes).
Travel up to 25% may be required.
Qualifications you will need:
Bachelor’s degree required. Master degree preferred.
10 years of relevant experience is required. Strongly prefer experience with Managed Care contract negotiation for either a hospital or MCO.
HCA Healthcare (Corporate) , based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleled resources and opportunities to reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education and career advancement opportunities , every person has a solid foundation for success. Nashville is also home to our Executive Development Program , where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our AVP Managed Government Programs opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.