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. Advanced 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. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr The CORE Institute