Executive Director, Payer And Public Health Relations

US Oncology, Inc. Dallas , TX 75201

Posted 2 months ago

Position Summary

Texas Oncology is searching for an Executive Director, Payer and Public Health Relations. The Executive Director, Payer and Public Health Relations is responsible for Government and Commercial payer relations and contracting strategies for Texas Oncology, Blood and Marrow Transplant Services and other business of Texas Oncology to maximize reimbursement and ensure continued practice growth.

Texas Oncology delivers high-quality, high-touch care to help cancer patients achieve "More breakthroughs. More victories." in their fight against cancer.

We are an independent, physician-led practice delivering leading-edge technology and treatment options and conducting innovative research. Founders of the practice pioneered community-based care to enable more cancer patients to receive high-quality care while staying close to the critical support of family and friends.

Texas Oncology has more than 150 sites of service throughout Texas, with more than 350 physicians dedicated to serving our patients. On average, we treat more than 50,000 new cancer patients each year, with documented growth year over year.

Texas Oncology pioneered the concept of community-based, outpatient, multidisciplinary cancer centers. We give local communities access to leading-edge technology that was previously only available in larger metropolitan areas. Texas Breast Specialists and Texas Urology Specialists are a part of Texas Oncology.

Texas Oncology is an affiliate of The U.S. Oncology Network, which is owned by McKesson Specialty Health, a division of McKesson Corporation.

Key Responsibilities:

  • Represents Texas Oncology to payers and regulatory authorities in matters related to reimbursement for services. Establishes and maintains crucial relationships with C-Level management and medical directors at major commercial payers to ensure an understanding of Texas Oncology's value proposition and capabilities. Fosters stronger partnerships with payers encouraging development of progressive reimbursement models.

  • With practice leadership establishes and maintains crucial contacts with Federal and State healthcare policy makers, key medical societies who influence policy.

  • Establishes and maintains crucial relationships with major employers and employer associations in the State of Texas to ensure their understanding of Texas Oncology's value proposition, and to establish first point of contact.

  • In conjunction with local Texas Oncology physician and management leadership, establishes critical relationships with key hospital or PCP group partners seeking to develop ACOs or similar integrated care models.

  • Communicates with management, physicians and other key stakeholders on the status of payer contract performance, current contracting efforts, problem issues and resolutions.

  • Effectively communicates trends and issues to management and physicians through regular reports or meetings.

  • Coordinates strategies with key constituents, including but not limited to Revenue Cycle leadership, the Texas Oncology Payer Contracting Steering Committee, Texas Oncology Public Policy Committee, Texas Oncology Operating Board, Marketing and Oncology Liaison leadership.

  • Understands that competitiveness depends on innovative product development. This position encourages development and evaluation of potential value enhancing programs for all service lines.

Qualifications:

BS/BA in Health Management, Business, or related field. Advanced degree preferred. 5 years managed care contracting (payer or provider side) experience.

The vision of Texas Oncology is to be the first choice for cancer care. We have high standards for patient satisfaction and offer exceptional value in cancer care. We also strive to advance clinical research and develop innovative approaches to treatment of oncology and hematology disorders.

The mission of Texas Oncology is to provide excellent, evidence-based care for each patient we serve, while advancing cancer care for tomorrow. To this end, we give patients access to the highest quality cancer care available today within their own local communities.

Our cutting-edge technologies, treatments and research are offered in welcoming and comfortable environments. We maintain comprehensive quality oversight and responsible financial management. At all times, we pride ourselves in being moral, ethical and efficient as a medical practice and employer.

We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-k with a matching component, Life Insurance, Short-term and Long-term disability and Wellness & Perks Programs.

Come join our growing organization and enjoy knowing that you work for an organization dedicated to making the lives of others better.

The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.

Category: Administrative

Post to:

  • HEC
  • M

The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.

","title":"Executive Director, Payer and Public Health Relations



See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Assistant Executive Director RN Home Health Full Time 2500 Sign On Bonus

LHC - Icims

Posted 6 days ago

VIEW JOBS 11/12/2018 12:00:00 AM 2019-02-10T00:00 OverviewLHC Group is the preferred post-acute care partner for hospitals, physicians and families nationwide. From home health and hospice care to long-term acute care and community-based services, we deliver high-quality, cost-effective care that empowers patients to manage their health at home. Hospitals and health systems around the country have partnered with LHC Group to deliver patient-centered care in the home. More hospitals, physicians and families choose LHC Group, because we are united by a single, shared purpose: It's all about helping people. The Assistant Executive Director assists the Executive Director in all functions of administrative oversight of the provider. This includes: coordinating and completing assigned projects to effectively support the immediate and long range objectives of the company; oversight of the eligibility of patients referred to home care services, planning for the services to be provided to patients and supervising their total home health care; implementing and maintaining administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations; enhancing the profitability of the agency; and providing motivation and retention of a qualified staff and assure the quality of services delivered. This position also acts as a liaison with management staff and other departments throughout the company.Additional Details Essential Functions * Responsible for continual compliance with all federal and state regulations, laws, and policies and procedures applicable to Home Health. Maintains personal knowledge of up-to-date federal, state, and Joint Commission regulations. * Employs qualified individuals and accepts responsibility for daily agency operations of the whole provider. * Ensures that the Clinical Director is available during all operating hours or directly provides coverage for those duties. * Must be immediately available to be on-site during business hours, or immediately available by telephone when off site conducting agency business, including but not limited to community presentations, conferences, and meeting with physicians. Available after hours as needed. * Responsible for directing day to day operations of the provider. * Supervises all patient care activities to ensure the delivery of safe, economical, and efficient patient care,which adheres to relevant standards of accepted nursing and medical practice, to include federal and state regulations, and Joint Commission standards, as well as to ensure compliance with payer source criteria. * Assists in policy review and revisions as requested to establish and support the highest possible quality of patient care, cost controls, quality assurance, and staff performance. Ensures that established policies are enforced. * Provides and / or ensures patient care according to the plan of care as ordered by the physician. * Provides timely performance evaluation of personnel. * Assures regularly scheduled continuing education for personnel and supervises compliance of staff with online learning management courses. * Provides supervision to direct reports on an on-going basis to ensure compliance. * Assists with staff recruitment to ensure that adequate staffing is maintained. Operates within the staffing model. * Conducts at least monthly meetings with the medical director. Approves medical director invoices and submits on a monthly basis to the Home Office with appropriate supporting documentation for timely payment. * Ensures that only qualified personnel are hired. Oversees licensure verification, certification, and credentialing as required by law and policy prior to employment and annually thereafter. On an on-going basis, ensures maintenance of records to support competency of all personnel. * Adheres to and supports the Episode Management Model within the provider via Episode Management supervision. * Assures compliance with and ensures timely follow up on daily external vendor clinical edits, outcome support, and coding edits. * Acts as a liaison between staff, patients, and upper management to ensure information is shared appropriately among the LHC team. * Ensures that all services are billed as per federal, state, and LHC guidelines as provided to the proper payer source. * Ensures adequate staffing of agencies, as well as adequate staff education on an initial and on-going basis and staff evaluations on a new hire and annual basis. * Implements and maintains an effective budgeting and accounting system on an annual basis. Provides input to the budgeting process as appropriate. * Oversees an effective QAPI program ensuring improvement plan execution and follow-up. * Serves as a member of the Management Team, QAPI Team, and other committees as assigned within designated timeframes. Participates in annual strategic agency planning. * Reviews weekly Operations Spreadsheet, weekly Metrics Report, and weekly Productivity Report to ensure the organization is on target with budget goals. Follows up as needed. * Oversees weekly reports, including claims alert, late EMS, unverified services, and orders audit, to ensure timely and accurate billing and payroll. * Supervises the maintenance and accuracy of patient care and employee records. * Performs staff conferences as needed and mandatory in-services, including but not limited to monthly staff/safety meeting. * Any other duties as assigned. QualificationsLicense Requirements * Registered nurse with at least 1 year supervisory or administrative experience in a home healthcare or a related field. * Current CPR certification required. * Current Driver's License and vehicle insurance, and access to a dependable vehicle, or public transportation. Additional State Specific Requirements * CO: Must have 2 years healthcare or health service administration experience with at least 1 year of supervisory experience in home care or related health program. * LA: Must have 3 years of management experience in the delivery of health care service. * MS: Must be one of the following: (1) An individual with a baccalaureate degree and at least 1 year of administrative experience in home health care or in a related health provider program occurring within the last 3 years. (2) An incumbent administrator as of July 1, 198 (3) An individual with a minimum of 3 years of administrative experience in a health related field, 1 year of which shall be full-time in a home health setting, occurring within the last 3 years. * TX: Must not have been convicted of a felony or misdemeanor listed in Tag 9601(b). May also be the supervising nurse of the agency providing he/she meets the specific qualifications for supervising nurse. Must have evidence of 8 clock hours of educational training in the administration of an agency within the 12 months preceding designation of position per Texas Administrative Code. * VA: Must have 1 year within the last 5 years of supervisory or administrative management experience in home health or a related field. * AL, AR, AZ, CA, FL, GA, ID, IL, KY, MD, MI, MO, NC, OH, OR, PA, RI, SC, TN, WA, WI, WV - No additional requirements . LHC - Icims Dallas TX

Executive Director, Payer And Public Health Relations

US Oncology, Inc.