Director of Payor Contracting
Ivy Rehab Network
full-time
Posted on:
Location Type: Remote
Location: Florida • Pennsylvania • United States
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Job Level
About the role
- Overseeing payor contract directory activities, including submission of new clinicians and adds / changes to health plans.
- Advising the management team on emerging industry trends and methodologies in managed care contracting, payor relations, and legal issues.
- Monitoring new CMS requirements and ensures contract meet the requirements.
- Formulating and implementing strategies and initiatives for payor contracting strategies that support business growth and maximizing contract performance and yield.
- Possessing extensive market intelligence in order to negotiate strong contracts, and handle payor escalations when higher level issues need to be resolved.
- Assisting in evaluating new partnerships in collaboration with other functional teams.
- Daily oversight of the contracting teams including establishing metrics to measure performance, monitoring of overall quality, determining team priorities, and managing workflows.
- Identifying or creating tools, financial modeling systems or other resources to assist with payor contract evaluations.
- Ability to analyze complex data sets resulting in payor contract financial modeling.
- Creation of executive leadership and board level presentation materials for purposes of defining Ivy’s payor strategy.
- Engagement in thorough review of market expansion opportunities during due diligence of potential strategic partners and acquisitions.
- Liaison between Ivy operations and Payor partners to remediate payor issues including, but not limited to, claims, credentialing, & authorization.
Requirements
- Bachelor's Degree from an accredited institution preferably in Business Management, Healthcare Administration or equivalent.
- Minimum of 10+ years of experience in a payor contracts focused position in large, clinician-based healthcare networks.
- Must have 4+ years of management experience.
- 10+ years of experience in payor contract negotiations.
- Extensive experience working within a heavy managed care environment.
- Proven ability to solve complex issues and manage complex business relationships.
Benefits
- Eligibility for full benefits package beginning within your first month of employment.
- Generous PTO (Paid Time Off) plans and paid holidays.
- Collaborate with leaders like Hospital for Special Surgery (HSS) and educational partners for continuous learning.
- Professional development tracks, continuing education, leadership development, residency cohorts, mentorship programs, and many other resources.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
payor contract negotiationfinancial modelingdata analysiscontract performance measurementmarket intelligencecontract compliancestrategic planningbusiness growth strategiesmanaged care methodologiescontracting team management
Soft Skills
problem solvingrelationship managementleadershipcommunicationcollaborationorganizational skillsstrategic thinkinganalytical skillspresentation skillsnegotiation
Certifications
Bachelor's Degree in Business ManagementBachelor's Degree in Healthcare Administration