Director, Provider Contracting – MA Markets
Health Care Service Corporation
Director, Provider Contracting
Health Care Service Corporation
full-time
Posted on:
Location Type: Hybrid
Location: Chicago • Illinois, Texas • 🇺🇸 United States
Visit company websiteSalary
💰 $118,800 - $220,800 per year
Job Level
Lead
About the role
- Responsibility over MA National Risk partnerships, including CareAllies, encompassing contracting, partner retention, operations, growth, financial and quality performance and strategic planning.
- Achieve competitive advantage in discounts and access through contract negotiations and effective relationship management.
- Coordinate contracting with staff who may report directly to other Directors and Managers within Network Management, as needed.
- Oversee the analysis and reporting required to develop reimbursement strategies and take corrective action as needed
- Oversee the performance of negotiated health care provider compensation and appropriate reimbursement of medical costs
- Analyze monthly activity reports, budget and variance reports and formulate resolutions for problem trends.
- Identify deficiencies in reporting capabilities and coordinate development and implementation of needed methodologies.
- Develop, implement and maintain processes and standards for provider network expansion, contracting and servicing. Ensure that quality standards regarding the provider network are met.
- Directly manage staff including but not limited to: hiring, performance management, talent management, training, counseling, pay administration and change management.
- Assist in presentations to existing and potential customers.
Requirements
- Bachelor’s degree plus 5 years’ experience in hospital/health care contracting, and hospital/physician relations
- 5 years management experience
- Experience working with large integrated health care delivery systems and complex reimbursement strategies
- Experience proactively developing and maintaining relationships with health care provider leadership teams with propensity to build trust
- Knowledge of outpatient and provider reimbursement strategies and policies
- Experience with financial matters such as contract performance and impact including accuracy and sound judgment
- Experience proactively developing creative, win-win solutions considering the impact on the provider contract, network, marketability of the product, and profitability of the product
- Negotiation skills
- Leadership skills
- Team player/relationship oriented
- Clear and concise verbal and written communications skills including interpersonal skills, presentation skills to present to executives internally and externally, and team building
- Experience meeting deadlines and work well under pressure
- Experience working across departments to accomplish initiatives and goals, building consensus, driving initiatives, gaining support and developing workable solutions
- Ability and willingness to travel, including overnight stays
- Overseeing the annual budget and allocating resources for various projects and operational needs.
- Translating needs and initiatives into compelling business cases.
- Conducting cost-benefit analyses to justify investments and ensure ROI.
Benefits
- health and wellness benefits
- 401(k) savings plan
- pension plan
- paid time off
- paid parental leave
- disability insurance
- supplemental life insurance
- employee assistance program
- paid holidays
- tuition reimbursement
- other incentives
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
hospital contractinghealth care contractingreimbursement strategiesfinancial analysisbudget managementcontract negotiationprovider compensationdata analysismethodology developmentperformance management
Soft skills
leadershiprelationship managementcommunicationteam buildingproblem solvingpresentation skillscreativityconsensus buildingtime managementadaptability
Certifications
Bachelor's degree
