Director, Payor Contracting

Healthcare Outcomes Performance Company

Job Location:

Phoenix, NM - USA

Monthly Salary: Not Disclosed

Posted on: 10 hours ago

Vacancies: 1 Vacancy

Job Summary

ESSENTIAL FUNCTIONS
Develop and maintain positive effective relationships with internal and external customers and serve as the contracting
liaison between contracted Payors and providers.
Conduct contract analysis and negotiations with Payors on behalf of providers including rates payment methodologies
contract language and value- based payment programs in accordance with internal control processes for contract review
approval and signature.
Participate in Payor reimbursement analysis that can be routinely updated and maintained as a baseline for strategies to
maximize health plan reimbursement.
Research and make recommendations to executive leadership in regard to payor contracting opportunities in new and
existing geographic service area.
Ensure compliance in all business and contractual relationships
Identify and communicate trends and/or potential issues to management team.
Other duties and responsibilities as assigned.

EDUCATION
Bachelors Degree in Business Finance or Healthcare Administration required.

EXPERIENCE
Proven working knowledge of provider financial issues complex contracting options financial/contracting arrangements
and regulatory requirements.
5-7 years related experience and comprehensive level of negotiating skills with successful track record negotiating contracts
with payors.
Strong communication critical thinking problem resolution and interpersonal skills.
Solid understanding of industry dynamics required.

REQUIREMENTS
Familiarity with managed care products and services medical cost trend analysis including analysis of physician contracts
utilization and costs.
Must have prior experience working with managed care contracting modeling.
Familiar with a variety of concepts practices and procedures in the field of managed care.
Must be able to problem solve and come forward with recommendations. Must be able to stay on task with minimal supervision.
Excellent critical thinking troubleshooting and analytical skills.

KNOWLEDGE
Knowledge of payor reimbursement.
Managed care contracting.
Market and industry knowledge.

SKILLS
Strong verbal and written communication skills.
Strong organizational skills and careful attention to detail.
Advance computer skills.

ABILITIES
Ability to analyze problems and interpret information.
Able and to prioritize and reprioritize as necessary. Ability to work independently and as part of a team.
Ability to multi-task manages multiple projects and meets tight deadlines.

ENVIRONMENTAL WORKING CONDITIONS
Normal office environment.
Some travel within community.

PHYSICAL/MENTAL DEMANDS
Requires sitting and standing associated with a normal office environment.
Some bending and stretching required.
Manual dexterity using a calculator and computer keyboard.

Required Experience:

Director