Senior Director of Payor Relations and Contracting

Overview

Exceptional Opportunity For a Proven Sr. Director of Payor Relations & Contracting.

• Exceptional Benefits
• Team Building
• Growth Potential

• The role manages relationships with payers, lead negotiation, preparation, documentation and implementation of new and established contracts for facility and professional agreements with third party payers on of the health system including new programs and services.
• Oversee organizational contract development and management activities and enforce organizational principles of integrity and compliance
• Develops standards for contracts, including payment terms, general language and provisions based on strategy discussions, senior management input and organizational needs
• Evaluates rate proposals, changes to reimbursement methodologies and conduct related analyses to ensure continued financial viability of the contract
• Ensures contracts and proposals are properly entered into organizational databases to measure, track and monitor utilization and financial performance of managed care contracts
• Negotiates single case agreements to capture financial reimbursement from non-contracted entities
• Serves as primary organizational contact during payer contract negotiations
• Assists HPBS Department and internal customers with resolution of complex payer issues. Participate in Leadership meetings with third party payers to address contractual payment issues and trends
• Communicates and provides tools for contractual terms to other departments whose functions are necessary to the development, implementation and management of the provider arrangements.
• Responsible for the credentialing of Healthcare facilities which includes all associated clinics and new business ventures
• Must be strategic and forward thinking and 9 years plus experience
• Contracts Negotiations
• Managed Care, Medicaid, Medicare and Medicare Advantage contracting

Bachelors in Finance, Accounting, Healthcare Administration