Director Provider Contracting JHP
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Job Location:
Philadelphia, PA - USA
Monthly Salary:
Not Disclosed
Posted on:
11 days ago
Vacancies:
1 Vacancy
Job Summary
Job Details
The Director of Provider Contracting is responsible for leading the contracting initiatives and strategies across JHPs provider network. The Director Provider Contracting leads all end-to-end provider contract discussions for JHPs state-wide provider network.Job Description
Summary
The Director of Provider Contracting is responsible for leading the contracting initiatives and strategies across JHPs provider network. The Director Provider Contracting leads all end-to-end provider contract discussions for JHPs state-wide provider network.
Job Duties
- Oversees and leads negotiations of provider contracts for JHPs provider network.
- Manages day-to-day contractual relationship with the JHP provider network.
- Works with internal customers (e.g. provider reimbursement configuration and network account managers) to assist in resolving any issues arising from the provider network.
- Evaluates provider network gaps and proposes modifications to network.
- Recruits providers for provider network gaps in conjunction with the network development team.
- Maintains and fosters a collaborative relationship with internal and external customers.
- Manages contract portfolio budget and controls expenses while meeting operational network and service requirements.
- Manages the accurate and timely implementation of all provider contracts paying special attention to meeting all applicable regulatory requirements.
- Perform other duties as assigned.
Minimum Qualifications
- Bachelors Degree
- 5 years experience in managed care and provider contracting
- 3 years in a management (or equivalent level) position.
- Knowledge of managed care administration and standards regulations and laws applicable to contracting.
- Strong negotiation and conflict resolution skills required.
- Knowledge and understanding of claims processing member services and provider services as they relate to provider contracting.
- Excellent organizational interpersonal time management and communications skills.
- Process and project management ability.
- Strong Microsoft Office skills
- Auto insurance required.
- DL - Drivers LicensePA - State of Pennsylvania
Preferred Qualifications
- Preferred contracting experience.
- Experience in managing cross-functional projects and teams in claims customer service and/or provider affairs areas preferred.
Physical Demands
Lift and carry 25 lbs. frequent sitting/standing frequent keyboard use *patient care providers may be required to perform activities specific to their role including kneeling bending squatting and performing CPR.
Job Description Disclaimer: This position description provides the major duties/responsibilities requirements and working conditions for the position. It is intended to be an accurate reflection of the current position however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.
Work Shift
Workday Day (United States of America)Worker Sub Type
RegularEmployee Entity
Health Partners Plans Inc.Primary Location Address
1101 Market Philadelphia Pennsylvania United States of AmericaNationally ranked Jefferson which is principally located in the greater Philadelphia region Lehigh Valley and Northeastern Pennsylvania and southern New Jersey is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65000 people strong dedicated to providing the highest-quality compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrows professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic clinical and applied research. Thomas Jefferson University home of Sidney Kimmel Medical College Jefferson College of Nursing and the Kanbar College of Design Engineering and Commerce dates back to 1824 and today comprises 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8300 students. Jefferson Health nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.
Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age race color religion creed sexual orientation gender gender identity marital status pregnancy national origin ancestry citizenship military status veteran status handicap or disability or any other protected group or status.
Benefits
Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues including medical (including prescription) supplemental insurance dental vision life and AD&D insurance short- and long-term disability flexible spending accounts retirement plans tuition assistance as well as voluntary benefits which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues including those who work less than part-time(including per diemcolleagues adjunct faculty and Jeff Temps) have access to medical (including prescription) insurance.
For more benefits information please click here
Required Experience:
Director
Key Skills
- Fundraising
- Management Experience
- Coaching
- Analysis Skills
- Strategic Planning
- Team Management
- Budgeting
- Leadership Experience
- Mentoring
- Public Speaking
- negotiation
- Supervising Experience
About Company
At Thomas Jefferson University in Philadelphia, PA, we are helping you to redefine what’s possible with innovative and tailored education opportunities.
