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Lumexa Imaging este o companie de servicii medicale axată pe extinderea accesului la imagistică diagnostică avansată prin îngrijire ambulatorie și parteneriate cu sisteme de sănătate. Fondată în 2018, compania operează peste 185 de centre de imagistică în 13 state, inclusiv locații administrate în cadrul unor asocieri în participațiune. Aceasta sprijină pacienții prin programarea centralizată a consultațiilor, servicii ambulatorii convenabile și interpretări realizate de radiologi cu supraspecializări. Serviciul Connexia extinde aceste capacități prin teleradiologie, în timp ce inteligența artificială și echipamentele moderne de imagistică contribuie la susținerea calității clinice și a eficienței operaționale. Lumexa Imaging colaborează, de asemenea, cu sisteme de sănătate în cadrul unor modele de îngrijire colaborativă concepute pentru a îmbunătăți experiența pacienților și pentru a oferi, acolo unde este potrivit, o alternativă mai puțin costisitoare la imagistica ambulatorie din spitale.
Senior Director, Managed Care Contracting (Illinois Remote)
Lead payer contract negotiations, reimbursement strategy, and managed care initiatives for Lumexa Imaging. Oversee legal, financial, operational, and cross-functional contracting work.
Descriere
- Build and sustain productive relationships with payer representatives and leaders across assigned geographies and projects.
- Partner with joint venture managed care teams and other colleagues to meet contracting and operational goals.
- Direct the negotiation and execution of managed care payer and third-party contracts.
- Work with internal and external legal counsel to assess and document payer contract language against departmental and regulatory standards.
- Conduct contract language reviews and analyses as needed.
- Provide internal guidance on payer contract language questions and requests.
- Partner with financial analysts and business teams to prepare negotiation data and analyze claims or operational trends.
- Support team planning for contract negotiations and renewals by evaluating historical performance and identifying opportunities.
- Complete contracting activities for acquired facilities, new facilities, and new practices.
- Resolve contract-related claims and operational issues with internal and external customers, Managed Care Operations, and revenue cycle teams.
- Communicate new and revised contract terms to internal stakeholders.
- Create and maintain departmental tracking documentation.
- Lead special projects and complete other assigned responsibilities.
Cerințe
- Bachelor’s degree in business administration, healthcare administration, finance, law, or a related field is required.
- A master’s degree in business administration, healthcare administration, public health, or a Juris Doctor degree is preferred.
- At least 10 years of progressively responsible experience in managed care contracting, payer relations, or healthcare reimbursement, including extensive complex payer agreement negotiation experience.
- At least five years of leadership experience managing teams, projects, and organizational initiatives.
- Experience with hospitals, physician organizations, integrated delivery systems, or large multispecialty healthcare organizations is preferred.
- Proven record of developing and implementing contracting strategies that improve reimbursement, operational performance, and organizational results.
- Expertise in managed care contracting principles, payer reimbursement methodologies, and healthcare payment models, including fee-for-service, value-based reimbursement, and alternative payment arrangements.
- Broad knowledge of commercial, Medicare Advantage, Medicaid managed care, and other third-party payer contracting practices.
- Strong understanding of healthcare regulations governing managed care contracting, reimbursement, and compliance.
- Advanced skills in contract negotiation, drafting, interpretation, and language analysis.
- Exceptional financial and analytical ability, including evaluating reimbursement methodologies, recognizing trends, and developing data-driven negotiation strategies.
- Demonstrated ability to lead complex negotiations and influence internal and external stakeholders toward favorable outcomes.
- Strong strategic planning, project management, and organizational skills, with the ability to manage competing priorities and deadlines.
- Excellent written, verbal, and presentation communication skills.
- Demonstrated ability to build collaborative partnerships across executive leadership, operations, finance, legal, revenue cycle, and clinical teams.
- Strong leadership, coaching, and team development capabilities, including experience cultivating a high-performing, collaborative workplace.
- Ability to exercise sound judgment, protect confidential information, and make informed decisions in complex or sensitive circumstances.
- Proficiency with Microsoft Office, contract management platforms, and healthcare financial and claims reporting tools.
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