Executive Director of Managed Care Contracting - Health Services Contracting (HYBRID)

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County.

To learn more about UCI Health, visit www.ucihealth.org.

Position Summary:

Incumbent defines and implements strategy and contract performance expectations for the enterprise. The incumbent is responsible for managing and directing a staff of contracting professionals that negotiate and draft contracts with aggregate impact more than $1.5 billion. The incumbent is responsible to suggest and implement innovative reimbursement strategies, including value-based care, bundled payment programs and initiate participation in innovative networks/programs to optimize financial performance, while helping to prioritize the team efforts to maximize our growth opportunities. The incumbent provides effective drafting, review, negotiation, execution, implementation, and evaluation of all contracts including, health plan, clinical services, ancillary, and other contracts that support the Enterprise. The incumbent establishes, implements and maintains contract relationships with referral medical groups, referral hospitals, health plans and other third-parties to enable patient referrals. The incumbent will report to the Executive Director, Enterprise Managed Care Contracting.

Required Qualifications:

• Working knowledge of complex provider relations, credentialing activities.
• Thorough understanding current reimbursement methodologies and ability to distinguish the most effective method for each situation.
• Must demonstrate customer service skills appropriate to the job
• Must be self-motivated and goal driven.
• Minimum of 3 years' management experience in a highly complex, diverse health care organization
• Minimum 8 years' provider contracting experience in a managed care environment, including negotiation, preparation, review, administration, maintenance, and monitoring of contracts.
• In-depth knowledge of Medicare and MediCal policies, practices, and reimbursement strategies
• In-depth knowledge and experience in managed care, value-based contracting, Medicare Advantage, capitation, narrow networks, and other innovative payment models.
• Extensive experience dealing with payors or providers.
• Evidence of sound critical thinking skills and the ability to think creatively and strategically to problem solve
• Demonstrated ability to interact effectively, build trust and establish effective working relationships across the Health System and with a wide variety of audiences
• Bachelor's degree in business, Finance, Healthcare or related discipline or equivalent experience
• Ability to maintain a work pace appropriate to the workload
• Ability to implement business plans and contracting activities to achieve objectives.
• Ability to critically evaluate options, tradeoffs within contracting opportunities.

Preferred Qualifications:

• Master's Degree

Total Rewards

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.

Conditions of Employment:

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:

• Background Check and Live Scan
• Employment Misconduct*
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment

Exercise the utmost discretion in managing sensitive information learned in the course of performing their duties. Sensitive information includes but is not limited to employee and student records, health and patient records, financial data, strategic plans, proprietary information, and any other sensitive or non-public information learned during the course and scope of employment. Understands that sensitive information should be shared on a limited basis and actively takes steps to limit access to sensitive information to individuals who have legitimate business need to know. Ensure that sensitive information is properly safeguarded. Follow all organizational policies and laws on data protection and privacy. This includes secure handling of physical and digital records and proper usage of IT systems to prevent data leaks. The unauthorized or improper disclosure of confidential work-related information obtained from any source on any work-related matter is a violation of these expectations.

*Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php

Closing Statement:

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy.

We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday - Friday from 8:30 a.m. - 5:00 p.m.