Director, Payor Contracting

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 · Bachelor’s 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.