VP, Managed Care

Primary Responsibilities:

• Responsible for vendor selection through Request for Proposal process, due diligence and contracting.
• Manage and audit vendors and develop strategies for improved processes and cost savings solutions.
• Oversee and maintain day-to-day operations of all managed care vendor programs, effectiveness and results.

Product and Business Development:

• Continuous development of product solutions to improve cost containment savings.
• Responsible for setting the vision and implementing strategies for creative cost containment initiatives.
• Present business solution to Claims Executive staff and other key stakeholders.

Management and Communication:

• Develop, maintain, and manage a Managed Care Scorecard that encompasses all cost containment services.
• Audit, measure, report and evaluate all vendor’s performance.
• Regular communication to Claims Leadership and other stakeholders on results and areas of focus and improvement.