Director, Provider Contracting
Health Care Service Corporation
Executive Director, Provider Contracting
Health Care Service Corporation
full-time
Posted on:
Location Type: Hybrid
Location: Chicago • Illinois, Texas • 🇺🇸 United States
Visit company websiteSalary
💰 $158,300 - $293,800 per year
Job Level
Lead
Tech Stack
Spring
About the role
- Responsibility over all Health Spring Eastern Region MA contracting decisions and outcomes- including managing terminations, adequacy, affordability for 33 states and national partnerships.
- Accountable for the development, negotiation and successful completion of reimbursement contracts. Ensure appropriate coverage of networks for locations.
- Achieve competitive advantage in discounts and access through contract negotiations and effective relationship management.
- Develop strategies, draft agreements and negotiate contracts for newly recognized categories of providers.
- Oversee the analysis and reporting required to develop reimbursement strategies and take corrective action as needed.
- Oversee the performance of hospital audits and appropriate reimbursement of hospital costs.
- Accountable for resolution of issues and contractual disputes.
- Ensure staff meets/exceeds goals, objectives and initiatives. Ensure staff is trained, positions are filled, and employees receive communications on changes, etc.
- Accountable for budget, operational reporting and financial reporting.
Requirements
- Bachelor degree and 6 years experience in health care/insurance administration, hospital/health care contracting, and hospital/physician relations OR 8 years experience in health care/insurance administration, hospital/health care contracting, and hospital/physician relations.
- 5 years management experience.
- Knowledge of hospital and provider reimbursement strategies and policies.
- Clear and concise verbal and written communications skills including interpersonal skills to represent company to external entities, negotiate contracts, resolve issues, and prepare executive and employee presentations.
- Ability and willingness to travel.
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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
contract negotiationreimbursement strategieshospital auditsfinancial reportingoperational reportingbudget managementprovider reimbursement policies
Soft skills
communication skillsinterpersonal skillsrelationship managementproblem resolutionstrategic developmentteam management
Certifications
Bachelor degree
