Director, Payor Relations

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Summary:

The Director of Payor Relations is responsible for developing and maintaining meaningful and effective relationships with managed care organizations and internal staff with the goal of securing managing and renegotiating viable revenue generating health care service contracts on behalf of CCHCS entities and providers with both commercial and government funded managed care organizations. The Director will manage payor intelligence contract implementation and validation as well as oversee issues and follow up on contract related claims issues.

Qualifications:

• Bachelors degree preferred.

• At least ten (10) years of operational experience in a manage care setting required.

• Extensive experience in contract negotiation and payor relations required.

• Superior knowledge of medical terminology.

• Must be able to foster and maintain healthy relationships with outside payors. Must have a clear understanding of the intricacies of commercial state and federal government funded insurances.

• Must be detail oriented with a high level of verbal and written communication skills.

• Must have high level of problem solving and presentation skills.

• Must be able to work independently effectively supervise staff and actively participate as an integrated team member.

About Us:

Cook Childrens Health Care System

Cook Childrens Health Care System offers a unique approach to caring for children because we are one of the countrys leading integrated pediatric health care delivery organizations. Patients benefit from the integrated system because it allows Cook Childrens to use all of its resources to treat a patient and allows for easy communication between the various companies by physicians with a focus on caring for children and adolescents.

Cook Childrens is an equal opportunity employer. As such Cook Childrens offers equal employment opportunities without regard to race color religion sex age national origin physical or mental disability pregnancy protected veteran status genetic information or any other protected class in accordance with applicable federal laws. These opportunities include terms conditions and privileges of employment including but not limited to hiring job placement training compensation discipline advancement and termination.