Job Opportunities

Are you looking to take your career to new heights with a leader in healthcare? SUNY Downstate Health Sciences University is one of the nation's leading metropolitan medical centers. As the only academic medical center in Brooklyn, we serve a large population that is among the most diverse in the world. We are also highly-ranked by Castle Connolly Medical, a healthcare rating company for consumers, among the top 5 leading U.S. medical schools for training doctors.

Bargaining Unit:

UUP

Job Summary:

The Department of Hospital Finance at SUNY Downstate Health Sciences University is seeking a full-time TH Supervising Financial Analyst / Director of Managed Care.

The Managed Care Director is a key role responsible for overseeing and optimizing managed care contracts and relationships within the organization. This individual will play a pivotal role in managing network performance, and ensuring the organization's compliance with regulatory requirements. The Managed Care Director will collaborate with various departments to develop and implement strategies that enhance the organization's financial performance and improve patient access to quality healthcare services.

Duties and Responsibilities Include:

• Contract Management:
  • Analyze contract terms and conditions to identify opportunities for improvement and mitigate risks.
  • Monitor contract performance and ensure compliance with contractual obligations.
• Provider Network Development:
  • Identify and evaluate potential network providers to expand and enhance the organization's provider network.
  • Build and maintain relationships with network providers to ensure alignment with organizational goals and objectives.
  • Collaborate with provider relations teams to address provider concerns and optimize network performance.
• Financial Analysis and Reporting:
  • Conduct financial analysis of managed care contracts to assess profitability and identify areas for improvement.
  • Develop and maintain financial models to forecast revenue and analyze contract performance.
  • Prepare regular reports and presentations for senior leadership on managed care financial performance and trends.
  • Manage and oversee the full development of cost-accounting functionality in Med-Metrix, including the establishment of combined IP/OP product lines
  • Update and maintain Hospital Charge-master.
• Regulatory Compliance:
  • Stay abreast of changes in healthcare regulations and managed care policies.
  • Ensure compliance with state and federal regulations related to managed care contracts.
  • Work closely with legal and compliance teams to address regulatory issues and mitigate compliance risks.
• Strategic Planning:
  • Collaborate with senior leadership to develop strategic initiatives aimed at optimizing managed care performance and enhancing patient access to care.
  • Participate in strategic planning processes to align managed care goals with organizational objectives.
  • Recommend innovative strategies to improve reimbursement rates and reduce costs.
• Other duties and responsibilities as required

Required Qualifications:

• Bachelor's Degree in healthcare administration, business administration, or a related field
• Minimum of 5 years of experience in managed care contracting and negotiation, preferably in a healthcare organization
• Or education, training and/or experience equivalent to above

Preferred Qualifications:

• Knowledge of value-based payment models and alternative payment arrangements.
• Experience working with healthcare payers and understanding of payer operations.
• Strong understanding of healthcare finance, reimbursement methodologies, and regulatory requirements.
• Excellent negotiation skills with a proven track record of successfully negotiating managed care contracts.
• Analytical mindset with the ability to interpret complex financial data and make data-driven decisions.
• Exceptional communication and interpersonal skills, with the ability to collaborate effectively with internal and external stakeholders.
• Demonstrated leadership abilities with experience leading cross-functional teams and driving strategic initiatives.

Work Schedule:

Monday to Friday; 9:00am to 5:00pm (Full-Time)

Salary Grade/Rank:

Salary Range:

Commensurate with experience and qualifications

Executive Order:

Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation.  If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.gov.

Equal Employment Opportunity Statement:

SUNY Downstate Health Sciences University is an affirmative action, equal opportunity employer and does not discriminate on the basis of race, color, national origin, religion, creed, age, disability, sex, gender identity or expression, sexual orientation, familial status, pregnancy, predisposing genetic characteristics, military status, domestic violence victim status, criminal conviction, and all other protected classes under federal or state laws.

Women, minorities, veterans, individuals with disabilities and members of underrepresented groups are encouraged to apply.

If you are an individual with a disability and need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please contact Human Resources at ada@downstate.edu