Director of Provider Network Performance

Birmingham, MI - USA

Monthly Salary: Not Disclosed

Posted on: 30+ days ago

Vacancies: 1 Vacancy

Job Summary

Overview

NaphCarehas an excellent opportunity for a Director of Healthcare Contract Management to join ourState Prisons team at ourCorporate Headquarters office locatedinBirmingham AL.

*This is an on-site position.

NaphCareisone of the largest providersof healthcare services to correctional facilities throughout the United States. NaphCare is a family owned healthcare technology company that has been delivering high quality healthcare to correctional facilities across the nation forover36 years.

NaphCare partners with correctional facilities to provide proactive patient-focused join our growing team of7000 employees!

As theDirector of Healthcare Contract Managementyou will primarily be responsible for developing new and existing relationships with off-site community providers to ensure competitive rates and ensure contract language is aligned with government contract terms and state and federal statutes.

Responsibilities

TheDirector of Healthcare Contract Management functions as a liaison between NaphCare and our collaborative partners while leading all aspects of our Provider Networks including access analysis network operations and financial analysis related to payment and cost management. Additional responsibilities include and are not limited to:

Oversight of the managed care staff within the department including coordinating evaluating and overseeing the implementation of off-site managed care contracts and network usage develop and support managed care strategies and initiatives.
Developing solidifying and maintaining relationships with community hospitals and large provider groups.
Evaluating negotiating and securing financially and administratively favorable contracts with new and existing community providers.
Leading and participating in activities that result in improved contract performance which includes performing payment analysis and responding to community provider concerns and questions.
Developing and fostering effective collaboration between clinical departments divisions medical staff leadership and other affiliated services to ensure an integrated approach to providing services and fulfilling the organizations clinical and operational goals and objectives.
Effectively communicating key information to the staff and stakeholders of these service areas.
Overseeing analysis of claim trend data and/or market information to derive conclusions to support contract negotiations and network usage.

Qualifications

Bachelors degree required masters degree preferred.
Minimum of 5 years experience in healthcare operations healthcare administration or healthcare finance at the administrative leadership level.
Minimum of 5 years of staff supervisory experience with demonstrated leadership and complex organizational management skills.
Minimum of 5 years of healthcare reimbursement contracting.
Must possess strong written and verbal communication skills well-developed planning organizational development and professional business skills.
Must have the ability to maintain confidentiality of all proprietary and/or confidential information and integrity professionalism and ability to adhere to a Code of Conduct and comply with all facility(s) correctional healthcare policies procedures and legal requirements.

NaphCare Benefits Package:

NaphCare offers competitive benefits including health prescription dental vision Employment Assistance Program (EAP) services and 401(k). NaphCare offers term life insurance at no cost to the employee and also provides PTO paid holidays and an array of voluntary benefits. Employees enrolled in our health insurance program receive prescriptions free of charge when filled at our in-house pharmacy or mail order program.

Want a better idea of what its like to work in correctional healthcare for thefederal state and local government

Life at NaphCare: Inside Correctional Healthcare: Care That Makes a Difference
Life at NaphCare: Autonomy
Life at NaphCare: Safety
Life at NaphCare: Skill Building & Professional Development Opportunities
Life at NaphCare - Life as a NaphCare Nurse Practitioner
NaphCare - Life as an LPN - YouTube

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities skills efforts or working conditions associated with a job.

Please note the duties and responsibilities listed are subject to change based on the needs of the organization.

Equal Opportunity Employer: disability/veteran

#NCE

Required Experience:

Director

OverviewNaphCarehas an excellent opportunity for a Director of Healthcare Contract Management to join ourState Prisons team at ourCorporate Headquarters office locatedinBirmingham AL.*This is an on-site position.NaphCareisone of the largest providersof healthcare services to correctional facilities ...