Vice President, Managed Care

BayCare Health System

  • Location: Tampa, FL

Overview

BayCare was formed in 1997 by a core group of local hospitals determined to continue providing not-for-profit health care to the Tampa Bay community. Today, BayCare is a 15-hospital health system with its own Medicare Advantage HMO product, BayCarePlus and $4.4 billion in revenue. The organization includes over 600 employed providers and nearly 30,000 employees. BayCare was ranked in the top 20 percent of large US Health systems by IBM Watson Health on metrics designed to measure the health of hospital systems and the quality of care they provide. In addition, BayCare was named by Fortune as one of the Top 100 Great Places to Work at number 37 on the list.

Reporting to the Executive Vice President and Chief Financial Officer, the Vice President, Managed Care will oversee the organization’s managed care strategy and be the principal liaison with insurance companies. This role will oversee all aspects of negotiating managed care contract reimbursement rates, structures, contractual language, and terms in accordance with established goals. In addition, the Vice President, Managed Care will oversee the Managed Care Decision Support and Managed Care Compliance teams and will be accountable for ensuring the division fulfills its role to advance the overall vision and strategy of BayCare Health System.

Qualifications

  • Bachelor’s Degree required; Master’s Degree preferred with 15 or more years of progressively increasing leadership experience in managed care contracting and payor relations, ideally within a large integrated delivery system or managed care payor.
  • Strong negotiation skills and experience in crafting managed care agreements that deliver positive outcomes across all aspects of the delivery system. Expertise in innovative contracting and risk modeling approaches is essential.
  • Proven ability to partner with multiple stakeholders to achieve operational objectives as well as develop policies and procedures compliant with state and federal regulations, NCQA standards and healthcare contract performance requirements.
  • Leadership depth in the formation of high-performing teams; ability to provide coaching and mentorship of future talent.
  • Through partnership with health plan and health system leaders, experience driving discipline, consistency, and execution of standardized initiatives and best practices. Ability to facilitate mechanisms to utilize pilots, measure results, and ultimately identify best practices to be used across the health system.