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Cottage Health
Director of Contracting/Managed Care
Santa Barbara, CA

Location and Position Description:

Santa Barbara is known all over the world for its exceptional beauty and over 300 days of sunshine a year. Located on the Pacific Coast of California, Santa Barbara is a 2 hour drive north from Los Angeles or a short hop from any corner of the world via the Santa Barbara airport. Santa Barbara is not only a beautiful place to live, the area is also fortunate to have an abundance of activities, employment opportunities, and resources at its disposal. Dozens of unique towns and cities are also nearby, hidden gems with plenty of things to see and do. Each has a personality of its own, from urban chic to down-home country.

The Director of Contracting is responsible for the analysis, contract negotiation, data management, implementation, contract maintenance, and problem resolution of all hospital services and physician/ambulatory service related contracts with commercial and Medicare and Medicaid payors relating to services provided by Cottage Health and all of their entities and affiliates. The Director will be aware of the regional managed care market conditions and ensure that Cottage Health is best positioned given the environment.

The Director will serve as an internal consultant and advisor to the CFO, colleagues, and the leadership team, collaborating on organizational planning and implementation of the managed care strategic, operational, and service design for the region while supporting/designing value based purchasing, risk, and any key insurance/managed care network relationships. He/she will be responsible for monitoring all aspects of the managed care department and services delivered. The position will report directly to the Chief Financial Officer.

Qualifications:

• Bachelor’s degree in finance, economics, healthcare administration or related field required.
• Master’s degree preferred.
• Seven years experience in a related field at an insurance company or healthcare environment required.
• Previous experience in managed care contracting, negotiations, and implementation in both provider and payer setting.
• A team player who has worked in a similar size health system with multiple entities and constituencies.
• An innovative style that creates new ways to develop business and enhance revenue.
• Experience working collaboratively with physicians and developing strong physician relationships.
• Knowledge of Medicaid and Medicare and their payment methodology is required.
• Ability to analyze and quantify complex sets of both hard and soft data.
• Knowledge of healthcare industry, hospital systems and managed care concepts.
• Experience on both the provider and payer side a plus.

Responsibilities:

• Perform ongoing monitoring of governmental and commercial payer environment to include emerging exchange based health plans, disseminates information to enhance compliance and performance.
• Direct the analysis and reporting of reimbursement information including cost analysis and rate studies.
• Develop managed care contracting and revenue enhancement strategies with commercial insurance companies, HMO’s and government insurance organizations to include Medicare and Medicaid.
• Develop managed care relationships with payers, physicians, employers, regulators, members, facility providers and government officials.
• Lead financial recovery projects against payers not abiding by contract terms and has oversight of any cost report re-filings.
• Initiate, develop, and analyze revenue potential for governmental and non-governmental reimbursement for hospital and professional services for the organization.
• Oversee payer relations committees, providing forums for exchange of pertinent ideas and activities across the enterprise.
• Participate in building provider network in the region to support clinical integration and accountable care.

About Cottage Health:
Cottage Health was formed in 1996 as the not-for-profit parent organization of Santa Barbara Cottage Hospital and its affiliated Cottage Children’s Medical Center, Cottage Rehabilitation Hospital, Goleta Valley Cottage Hospital, and Santa Ynez Valley Cottage Hospital. The organization is guided by a volunteer Board of Directors from the greater Santa Barbara community and provides the residents of the Central and south coast of California with exemplary healthcare, continuous improvements in medical practice, and a commitment to community health. With nearly 600 inpatient beds, the organization has a significant market share in its primary service area being the sole provider of acute care services in the area. Cottage Health provides the only Level II Adult and Pediatric Trauma Center on the Central Coast and has an array of inpatient and outpatient, medical/surgical, and rehabilitation services.

The organization is well-regarded for excellence in numerous service lines and is a teaching hospital with 57 physicians in residency programs including General Surgery, Internal Medicine and Radiology. The system has an active research program and the only independent biomedical IRB (Institutional Review Board) on the Central Coast. Cottage Health has strong financial performance with annual net revenues exceeding $750 million. The organization is profitable, has an excellent bond rating, and solid support from the Santa Barbara Cottage Hospital Foundation, Cottage Rehabilitation Hospital Foundation, Santa Ynez Valley Cottage Hospital Foundation, and Goleta Valley Cottage Hospital Foundation; the charitable organizations that support the enterprise. The system is known for a highly skilled Board of Directors, an outstanding and dedicated senior leadership team, top quality physicians and a highly engaged staff.


To Apply:

Please apply or direct all nominations and inquiries/resumes to April Allen, preferably via e-mail, to: CH-DirContracting@wkadvisors.com or call 877-228-4030.



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