Job Summary:
Plans, implements and manages outside medical contracting program for the delivery of medical and technical services in the Southern California Region. Responsible for managing projects with significant policy, planning, financial and cost containment implications for the organization; identifies and develops contracted services which may be very large in magnitude such as inpatient services redesign, or organ transplantation services, and which may require successful negotiation within short time frames.
Essential Responsibilities:
Through use of a variety of financial and utilization data, as well as through interaction with Regional and Area Management, identifies areas of potential cost savings whereby use of, or contracting for, outside services would result in savings to the program.$ads={1}
Contracted services may range in complexity from those supporting inpatient services redesign to organ transplantation, shock wave lithotripsy, burn care, speech therapy and hearing evaluations.
Initiates the coordination, development and preparation of Regional contracts with outside providers for the delivery of medical and technical services.
Acts as the project coordinator on large contracting projects; supervises staff involvement in the planning and negotiation of contracting efforts.
Secures legal review of contracts and agreement terms.
Represents Regional SCPMG in dealings with outside providers, other entities and other regions.
Directs and reviews cost-effectiveness and qualitative analysis of proposed outside medical services programs and other analytical studies.
Provides regional staff support to Area Associate Medical Directors, Physician Managers and Medical Group Administrators by collecting and analyzing data pertinent to management issues.
Acts as a liaison to regional departments and makes recommendations on potential solutions and coordinates implementation efforts.
Reviews and analyzes new Federal/State Regulations.
Reports to Program Office and other entities as required concerning contracting structures as required by HCFA and other agencies.
Notifies appropriate SCPMG departments of potential impact.
Evaluates performance of professional services contracting staff.
Interviews, selects, and recommends hiring and/or termination of staff.
Coordinates SCPMG training program participation tracking system.
Monitors SCPMG employee participation in internal and external training and educational programs.
Basic Qualifications:
Experience
- Minimum five (5) years in health care management, including contract management and negotiation experience (usually three years).
Education
- MBA/MHA/MPH required.
License, Certification, Registration
- Accident and Health Insurance License (California) within 3 months of hire
Additional Requirements:
Demonstrated ability to:- Utilize interpersonal skills, strong analytical and quantitative skills.
- Work with all levels of the organization in all entities.
- Supervise staff.
- Strong written and verbal communication skills.
- Demonstrated ability to negotiate and monitor/evaluate outside provider contracts and reimbursements.
- Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications:
- N/A.
PrimaryLocation : California,Pasadena,Walnut Center - Regional Offices
HoursPerWeek : 40
Shift : Day
Workdays : Mon, Tue, Wed, Thu, Fri
WorkingHoursStart : 08:00 AM
WorkingHoursEnd : 05:00 PM
Job Schedule : Full-time
Job Type : Standard
Employee Status : Regular
Employee Group/Union Affiliation : NUE-SCAL-01|NUE|Non Union Employee
Job Level : Manager with Direct Reports
Job Category : External Medical Services
Department : Regional Offices - Pasadena - Rgnl Mg Admn-Contracting - 0806
Travel : Yes, 15 % of the Time
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.
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