VP, Contracting and Managed Care (Hybrid)

Work Location
Orange, California

Work Shift
Day - 08hrs (United States of America)

Why CHOC?

At CHOC, we strive to be the leading destination of children's health by providing exceptional and innovative care. We are responsible for the overall health of our community's pediatric population in our hospitals, clinics, and practices. And because of our breadth of care, your career at CHOC can be as diverse and fulfilling as you determine. CHOC's compensation structure, benefits offerings, and career development programs are geared to helping you achieve your professional and personal goals. Apply now to see where your career at CHOC can take you.

Environmental Sustainability Statement

Driven by the connection between children's health and a healthy environment, we commit to creating a healthcare model that incorporates environmental sustainability aligned with our mission to protect children's health and patient safety.

Job Summary
Reporting to the Vice President, Finance & Accounting and Regional CFO, the Vice President of Managed Care Contracting leads the development and implementation of the managed care contracting strategy for the RCH Orange County Region and is responsible for negotiating, implementing, and monitoring of all hospital and professional FFS and Capitated payor contractual agreements. This executive is responsible for building and maintaining strong payer relationships, ensuring favorable reimbursement terms, working with operations and senior leadership to ensure contract terms align with business objectives and processes, managing risk-based contracts, and driving financial performance aligned with the organization's goals.

Pay Range
Minimum $65,770 Midpoint $563,285 Maximum $1,060,800

Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.

Experience

• Required: Minimum ten (10) years of progressively responsible experience in hospital managed care contracting, with at least five (5) years in a senior leadership role.

• Preferred: Over ten (10) years of experience as an Executive Director or Vice President.

Education

• Required: Bachelor's degree required;

• Preferred: Master's degree in business administration, Health Administration, or related field or Juris Doctor (JD) strongly preferred.

Training

• Required: Deep understanding of healthcare reimbursement models, including value-based care, risk sharing, and regulatory frameworks (e.g., CMS, Medi-Cal).

• Preferred: Training in Leadership/Management Theory.

Specialized Skills

• Required: Effective communication, time management and organization skills. Able to demonstrate strong collegial relationships and quality performance. Strong supervisory and leadership skills. Able to relate and communicate positively, effectively, and professionally with others; provide leadership; be assertive and consistent; work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction. Ability to take initiative and exercise independent judgment, decision making and problem-solving expertise. All Microsoft Office products.

Licensure

• Required: None required.

Work Environments - Functional Demand:
Sedentary - Very light energy level Lift 10 lbs. box overhead. Lift and carry 15 lbs. Push/pull 20 lbs. cart.

Physical Activity Requirements:
Bending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation

Physical Activity Lifting
Lifting (Floor to waist level) - Occasional 0-35%, Lifting (Waist level and above) - Occasional 0-35%

Sensory Requirements:
Color Discrimination, Depth Perception, Far Vision, Hearing, Near Vision

Environment Requirements:
Airborn Communicable Disease, Bloodborne Pathogens, Chemical, Dust Particular Matter, Extreme Noise Levels, Extreme Temperatures, Radiation, Uneven Surfaces or Elevations

Non-Discrimination Statement:

CHOC does not discriminate on the basis of age, race, color, religion, national origin, ancestry, marital status, genetic information, disability, sex, gender (including pregnancy, breastfeeding, childbirth, lactation or related medical conditions), gender identity or expression, medical condition, sexual orientation, veteran status, military or uniformed service member status, or other protected characteristics in accordance with state and federal laws.

We encourage individuals from all backgrounds to apply for positions at CHOC, even if your experience doesn't align perfectly with the listed qualifications for a particular role, as your unique experience may be a great addition to our culture for another one of our opportunities.

If you desire support or accommodations throughout the Talent Acquisition process, please inform your Talent Acquisition Partner.