USC Human Resources Administration

Job code: 111099Director, Managed Care Contracting Services

Grade: K |Overtime eligible: No |Date approved: January 11, 2005

Summary

Provides administrative support for managed care contracting for a department within the School of Medicine. Works closely with departmental faculty and auxiliary departments to develop products and pricing, identify key managed care networks and payors and promote programs through an aggressive sales and marketing approach.

Accountability

Priority Time (%) Task (Performs other related duties as assigned or requested. The university reserves the right to add or change duties at any time.)


% Develops comprehensive financial and clinical services packages of department specific services for promotion to medical groups, health maintenance organizations, preferred provider organizations, etc.


% Meets with managed care network representatives. Encourages use of current contracts by marketing to network programs and the broadening of existing contracts into wider, multispecialty exclusive arrangements. Introduces contracts for packages of specific surgical services and other promotional products. Schedules and participates in meetings between departmental faculty and representatives from managed care organizations.


% Develops plans to identify and solicit managed care networks that are not contracted with the department.


% Participates in negotiation of final agreements as they effect department. Participates in the review and evaluation of contractual arrangements in coordination with staff.


% Implements new managed care programs in conjunction with faculty, staff and hospital administration. Keeps staff and faculty apprised of developments in the managed care marketplace.


% Assists in development of strategy to attract patients from participating managed care programs. Facilitates promotion of departmental programs to provider networks in conjunction with faculty.


% Assembles information and prepares materials for presentation to committees, faculty members, administrators and managed care networks.


% Monitors contract activity from development through implementation and servicing to completion. Apprises clinic and departmental administrators of progress and activity.


% Develops and maintains communication program with departmental faculty and clinic administration.
Emergency response/recovery:    
In the event of an emergency, the employee holding this position is required to "report to duty" in accordance with the university's emergency operations plan and/or the employee's department's emergency response and/or recovery plans. Familiarity with those plans and regular training to implement those plans is required. During or immediately following an emergency, the employee will be notified to assist in the emergency response efforts, and mobilize other staff members if needed.

Qualifications

Minimum education Preferred education
  • Bachelor's degree
  • Combined experience/education as substitute for minimum education
Master's degree
Minimum experiencePreferred experience
3 years 5 years
Minimum field of expertise Preferred field of expertise
Experience in a health maintenance organization or hospital. Knowledge of managed care financing, contracting issues and the managed care marketplace. Experience working with clinical faculty.
SkillsMachine/equipment
  • Analysis
  • Assessment/evaluation
  • Budget control
  • Budget development
  • Communication—written and oral skills
  • Consulting
  • Counseling
  • Development/fundraising
  • Graphic design
  • Interpretation of policies/analyses/trends/etc.
  • Knowledge of applicable laws/policies/principles/etc.
  • Marketing
  • Mediation
  • Negotiation
  • Networking
  • Organization
  • Planning
  • Problem identification and resolution
  • Project management
  • Research
  • Scheduling
  • Adding machine/calculator
  • Computer and peripheral equipment
  • Computer network (department or school)
  • Computer network (university)
  • Fax
  • Photocopier
Supervises level
May oversee student, temporary and/or casual workers.
Comments
 

Signatures

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The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

The University of Southern California is an Equal Opportunity Employer