R.A. Wylan & Co. Inc.,
Career Center

Healthcare Network Director - Risk management/ Payor Operations/ MSO

Location: Los Angeles, CA
Job Type: Direct Hire
Salary: $100,000.00 - $100,000.00
Date: 3/21/2018
Job ID: 02578966
Job Description
We are in search of a Client Delivery Director which means our client’s ideal candidate needs to have experience with both payor and provider/hospital with a strong ability to work/partner cross-functionally as needed.   Our client is a MSO which aims to manage the risk pool and financial risk for hospitals, medical groups and health systems. Need to be well versed in claims, utilization management (concurrent revenue), credentialing, financial aspects, customer service, lease management (high risk), contracting (client contracts), and network development.

many of our client's clients are the executive suite- CEO, CFO, so you should be well experienced making presentations to the executive level.
  • Demonstrated experience of the entire acute care hospital revenue cycle processes is required;
  • Successful experience leading in matrixed environment.
  • Understanding of the market, trends, competition, and key pain points for hospital executives.
  • Proven success in project management roles to include developing and implementing business initiatives, change management, and bringing together disparate team members to successfully deliver client solutions
  • Bachelor’s Degree preferred.
  • Five to seven years Management in a Revenue Cycle or Acute Health Care.
If you meet these requirements, read on:
Here is what you will be DOING:
  • Oversight management
  • Client Management
  • Client Advisor- you should have a strong understanding of risk bearing entities. This is a role where you will be seen seen by client as a decision maker, manage relationships with clients to build rapport and trust.
                Someone who can help the client make decisions and grow
  • Reporting and Analytics- hold regular board meetings to report the financial performance month to month (including income statements & balance sheets), contractor issues, and claims processes. This person will also analyze financials to develop recommendations to improve performance and/or grow business. So this means you should have a strong understanding of operational requirements.
  • Relationship
  • Responsible for management of on-site staff which may include Patient Access, Medicaid  Eligibility, HIM, Business Office functions.
  • Ongoing Client Leadership and Remediation (Issue Resolution). Identifies performance degradation and coordinate with Client Executive Leader, and the operational colleagues to ensure a mitigation plan has been implemented for the client.
  • Manage the P&L
  • Develop and implement action plans to address and improve deficiencies in process and performance as identified. 
  • Reports on performance to client leadership, and regularly quantifies the benefit/accomplishments has delivered.
  • Collaborates with on-site resources in service delivery and problem solving to maximize solution offering and client satisfaction.
  • Position coordinates with Client Executive Leader
  • Manage new Change Control Notices, from the time of development, client implementation,  potential finance notification and partnering with Client Management for potential contract amendment.
  • Internal Controls and Training.
Salary is based on experience and goes well into the 6 figures. Relocation is available.
Excellent Benefits:
Flexible Spending Account
Our client offers different spending accounts as a great way to set aside tax-free income to help pay for out-of-pocket and dependent care expenses.
Paid Holidays and Time Off  Our client recognizes the need to balance your career and personal time. They include paid time off and observe 9 paid holidays per calendar year in their benefits plan.
Retirement Plan Their 401(K) retirement plan gives you a convenient tool for investing in your future whatever your dreams are.
Additional Plans In addition to the other plans, we also offer these supplemental options: Long Term Care Plan, Disability Plan, Supplemental Life and Accidental Death and Dismemberment Insurance.
Should you meet the requirements, please email your resume to us for consideration. The interview process will move quickly.