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.
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
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
• Bachelor’s degree
in finance, economics, healthcare administration or related
• 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
• 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.
• 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
Develop managed care contracting and revenue enhancement
strategies with commercial insurance companies, HMO’s and
government insurance organizations to include Medicare and
Develop managed care relationships with payers, physicians,
employers, regulators, members, facility providers and
• 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
Oversee payer relations committees, providing forums for
exchange of pertinent ideas and activities across the
Participate in building provider network in the region to
support clinical integration and accountable care.
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.
Please apply or
direct all nominations and inquiries/resumes to
Allen, preferably via e-mail, to:
CH-DirContracting@wkadvisors.com or call 877-228-4030.