Director Managed Care Cover Letter

I am excited to be applying for the position of director managed care. Please accept this letter and the attached resume as my interest in this position.

In the previous role, I was responsible for direction, feedback, and performance review for Health System and physician managed care staff to achieve contract performance goals.

Please consider my qualifications and experience:

• Knowledge of Health Insurance ecosystems that have partnership potential
• Familiarity with operational and administrative requirements and pricing structures of ancillary, inpatient, outpatient and physician service such as fee-for-service, per diem, DRG, case rates, percent of premium, capitation risk, and other such reimbursement methodologies
• Strong management/supervisory and organizational skills
• Comfortable interfacing with people at all levels internally and externally
• In depth experience with Microsoft office suite of products including strong Excel spreadsheet and PowerPoint development skills
• Proven track record for consistently meeting or exceeding goals and objectives
• Has a demonstrable track record in strategic planning in the pharmaceutical, biotechnology or related industry
• Knowledge of principles of Managed Care, including plan types (HMOs, PPOs, ) and understanding of progressive health care dynamics, including Risk-Sharing

Please consider me for the director managed care opportunity. I am including my resume that lists my qualifications and experience.

Previously, I was responsible for consultative support to ACN leadership and management with respect to managed care and related issues, including employee medical benefit plans and service line issues and new innovative strategies in which Dignity and Abrazo collaborates with health plans and/or medical groups to increase the value of services we provide.

Please consider my experience and qualifications for this position:

• Able to relate cooperatively and constructively with medical staff, executives, staff, elected officials, and managed care companies
• Collaborate with field sales to team to develop and implement strategies to maximize access, awareness within these channels revenue and reimbursement rates
• Extensive experience negotiating oncology managed care contracts with payers/insurance companies on behalf of providers multi-site/multi-state level
• Knowledge of principles of Managed Care, including plan types (HMOs, PPOs, ) and understanding of progressive health care dynamics, including Risk-Sharing, value based reimbursement, medical policy and laboratory utilization management programs
• Experience in drafting and managing budgets, adherence to departmental budgets preferably in a healthcare setting
• Experience with the construction of data sets, preferably within a healthcare organization
• Previous experience as Medical Director is preferred
• Thorough knowledge of all business lines (i.e., hospital billing, hospital based billing, primary care, specialty billing, outside billing services, lab services, home health, mental health and special programs)

I submit this application to express my sincere interest in the director managed care position.

Previously, I was responsible for robust MSL interface with Health Care Professionals, Patient groups, Payers and Managed Care Organizations in specific region of US.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Managed Care Experience, Sales and Lab background preferred
• Pharmaceutical or biotechnology industry experience as a medical science liaison/director with a majority of the experience in the managed care and/or payer environment is highly preferred
• Excellent clinical, scientific and analytical skills
• Excellent written and verbal communication skills, motivated, and able to work in a team environment
• Experience in critical review analysis, interpretation of published medical literature/technical scientific literature, and presentation capabilities are necessary
• Relevant therapeutic area experience (Sleep, Hem/Onc, Pain, rare diseases) preferred
• Experience in successfully leading and managing teammates of varying experience levels and location
• Strong mission and values commitment

I would like to submit my application for the director managed care opening. Please accept this letter and the attached resume.

In the previous role, I was responsible for direction, feedback, and performance review for hospital and physician managed care staff to achieve contract performance goals.

My experience is an excellent fit for the list of requirements in this job:

• Manage deal pipeline (entire process, including negotiation and closing of complex deals with long lifecycle)
• Prioritize and manage deal roadmap
• Knowledge of DRG and other coding/reimbursement methods
• Excellent written, oral, and communications skills
• Success in persuasion, influence, and negotiation skills
• Management expertise, knowledge of data analysis, and statistics
• Able to handle day to day administrative routine, urgent situations
• Effectively monitor and develop the abilities of subordinates

I am excited to be applying for the position of director managed care. Please accept this letter and the attached resume as my interest in this position.

In the previous role, I was responsible for resolution to managed care contractual issues pertaining to contract interpretation and coding with payers.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Intermediate skills set in MS Office
• Essential Technical/Motor Skills
• Essential Mental Abilities
• Knowledgeable and competent to perform all essential functions
• Essential Sensory Requirements
• Sufficient mobility and strength to move within the facility, various environments external to the facility
• CCLU preferred
• Work requires strong negotiating skills, strong analytic and strategic thinking skills and supervisory skills