Director Medical Economics

Description

Apria Healthcare is one of the nation's leading providers of home respiratory services and various medical equipment including oxygen therapy, inhalation therapies, sleep apnea treatment and negative pressure wound therapy. Headquartered in Lake Forest, California, Apria owns and operates more than 550 branch locations throughout the United States and serves more than 1.2 million patients each year. Apria was the first company to obtain voluntary accreditation from The Joint Commission and has been continuously accredited for more than 25 years. Additional company information can be found at http://www.apria.com/ .

The Director Medical Economics is responsible for directing and developing analytical functions and processes to support decision-making relating to managed care contracting and/or product profitability. This position plays a key role in supporting the internal Managed Care Field organization and/or data-driven strategy development.

• Oversees development and refinement of pricing and/or profitability analytical tools and related policies & procedures
• Collaborates with other functions and directs analyses to support the field and senior leaders on the company in the development of strategies to improve current and potential operating earnings.
• Oversees the development of fee schedule and capitation rates
• Oversees the development/refinement of all payor-type and account-based revenue and profitability reporting, including capitation rate adequacy, reconciliation recovery and utilization for internal and client review
• Reviews contracts for compliance with pricing policies and exception approval
• Develops capitation risk-sharing terms and establishes rates for sales to managed care organizations (MCOs)
• Works with Managed Care Field leadership to ensure renegotiations/reconciliations of capitation inadequacies occur on a timely basis and achieve profitability expectations.
• Works effectively with other functions to facilitate decision making and implementation of contracts
• Supports company-wide initiatives through research and analysis as necessary
• Presents summarized findings, analyses and recommendations both orally and in writing to execute leadership
• Participates in contract negotiations as necessary
• Develops, maintains and provides oversight to department of financial and data analysts
• Supervises subordinate staff for development, project direction and production quality and quantity
• Responsible for hiring, coaching, performance appraisal and disciplining of subordinate staff.
• Performs other related duties as directed by supervisor.

Qualifications

• Education or experience equivalent to a four-year degree in Business or Finance or in a finance-related discipline
• At least (10) ten years of directly related professional experience, including at least 2 years in a managerial role
• Excellent communication skills in a variety of media, including written, oral and presentation skills
• Ability to meet changing business priorities and think strategically
• Demonstrated ability to manage, motivate and mentor staff in a fast-paced environment, as well as ability to work with persuasion and authority
• Demonstrated accountability for delivering on-time, high quality work
• Excellent analytical and technical skills
• Experience with SQL and Access

Physical Demands:

The physical demands described here are representative of those that must be considered by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Requires constant sitting and occasional standing and walking.
• Constant talking and hearing.
• Requires the use of hands to finger, handle or feel constantly.
• Ability to lift up to 10 pounds is an occasional requirement.
• Vision requirements include close vision, distant vision, peripheral vision and the ability to adjust focus.

WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• The employee is exposed to outside weather conditions when traveling.

Apria Healthcare is committed to providing all applicants and employees with equal access to employment opportunities, regardless of sex, race, age, color, national origin, disability, pregnancy, religion, genetic information, sexual orientation, transgender status, marital status, veteran status, or any other characteristic protected by federal, state, or local law ("protected classes"). This contractor and subcontractor shall abide by the requirements of 41 CFR 60-300.5(a) and 60-741.5(a). These regulations prohibit discrimination against qualified individuals on the basis of protected veteran status or disability, and require affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans and individuals with disabilities. AA/EOE, M/F/Disability and Vet