Executive Director, Managed Care Operations

Position Overview:

The Executive Director, Managed Care Operations role is responsible for establishing the vision and leading the processes that provide analytics within the Managed Care Operations area, specifically focusing on the financial performance of all third-party payors, acquisitions, and third-party reimbursement. The role works closely with the SVP of Payor Solutions and their leadership team, as well as the VP of Pricing, VP of RCM Finance, and VP of Managed Care Finance. Additionally, this position leads a team that offers senior management enhanced insights into Managed Care contract performance and develops strategies aimed at improving financial outcomes. The role also represents the Pricing Department in all M&A due diligence projects, managing the revenue compression analysis for each M&A initiative and highlighting any financial concerns to senior management.

Primary Responsibilities:

• Establishes the vision and leads the development for all analytics to support the Payor Solutions area which covers over $5B in revenue to the company. Directly supports Managed Care Pricing in terms of providing necessary information to model financial proposals to retain or win new managed care business.
• Acts as the primary support role to the SVP of Payor Solutions and the underlying department in the analyzing of 3rd party financial performance, ensure that proposed contracts/amendments are reviewed by department’s contract administrators and that payors are following contract provisions (including fee schedules). Position is a key lifeline to RCM organization in the establishment of new payor codes, leading annual CPT crosswalks, new technology reimbursement, etc.
• Represent Pricing Department on all M&A due diligence projects. Oversee the process to perform revenue compression analysis for each M&A project and highlight to senior management any financial concerns.
• Leads the implementation and support for any shared savings programs with our Managed Care Payors through various agreed upon approaches (e.g., hospital outreach acquisition credit process).
• Oversees that key items are analyzed and delivered to managed care organizations to support RFP requirements (e.g., GeoAccess reporting)
• Oversees process to develop market share reporting that guides the company as to where they may have potential issues (health plan access concerns, competitor stealing business, etc)

Minimum Requirements:

• A Bachelor’s degree or 15 years of equivalent experience in lieu of required.
• 10+ years of experience required, in Finance, Pricing, or Managed Care preferred.
• Project management experience in planning, implementing, and measuring success
• Knowledge of healthcare and managed care industry current and future trends, including a comprehensive knowledge of managed care industry standards and familiarity with government regulations
• Strong working familiarity with claims payment rules and their impact on laboratory services.
• Very strong financial acumen
• Ability to manage the complexities of multiple information systems to support decisions with analytics.
• Experience with high end financial reporting systems and analytics platforms such as Essbase, SAS, Tableau and Alteryx.
• Strong computer proficiency (MS Office)
• Excellent communication skills with prior experience working with senior level management

Application Window: Open through 3/5/2025

Pay Range: $180,000-$220,000 + bonus + equity

All job offers will be based on a candidate’s skills and prior relevant experience, applicable degrees/certifications, as well as internal equity and market data. 

The position is also eligible for an annual bonus under the Labcorp Bonus Plan.  Bonuses are payable based on corporate and/or business segment performance and are subject to individual performance modifiers.

Benefits: Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan.  Casual, PRN & Part Time employees regularly scheduled to work less than 20 hours are eligible to participate in the 401(k) Plan only.  For more detailed information, please click here. 

Labcorp is proud to be an Equal Opportunity Employer:

As an EOE/AA employer, Labcorp strives for diversity and inclusion in the workforce and does not tolerate harassment or discrimination of any kind. We make employment decisions based on the needs of our business and the qualifications of the individual and do not discriminate based upon race, religion, color, national origin, gender (including pregnancy or other medical conditions/needs), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. Additionally, all qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law.

We encourage all to apply

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