Director of Payor Contracting managing Ivy Rehab’s payer strategy and contracting with extensive experience in healthcare networks. Overseeing contract activities and collaborating with partners for growth.
Responsibilities
Overseeing payor contract directory activities, including submission of new clinicians and adds / changes to health plans.
Advising the management team on emerging industry trends and methodologies in managed care contracting, payor relations, and legal issues.
Monitoring new CMS requirements and ensuring contracts meet the requirements.
Formulating and implementing strategies and initiatives for payor contracting strategies that support business growth and maximizing contract performance and yield.
Possessing extensive market intelligence in order to negotiate strong contracts, and handle payor escalations when higher level issues need to be resolved.
Assisting in evaluating new partnerships in collaboration with other functional teams.
Daily oversight of the contracting teams including establishing metrics to measure performance, monitoring of overall quality, determining team priorities, and managing workflows.
Identifying or creating tools, financial modeling systems or other resources to assist with payor contract evaluations.
Ability to analyze complex data sets resulting in payor contract financial modeling.
Creation of executive leadership and board level presentation materials for purposes of defining Ivy’s payor strategy.
Engagement in thorough review of market expansion opportunities during due diligence of potential strategic partners and acquisitions.
Liaison between Ivy operations and Payor partners to remediate payor issues including, but not limited to, claims, credentialing, & authorization.
Requirements
Bachelor's Degree from an accredited institution preferably in Business Management, Healthcare Administration or equivalent.
Minimum of 10+ years of experience in a payor contracts focused position in large, clinician-based healthcare networks.
Must have 4+ years of management experience.
10+ years of experience in payer contract negotiations.
Extensive experience working within a heavy managed care environment.
Proven ability to solve complex issues and manage complex business relationships.
Benefits
Eligibility for full benefits package beginning within your first month of employment.
Generous PTO (Paid Time Off) plans and paid holidays.
Exceptional Partnerships: Collaborate with leaders like Hospital for Special Surgery (HSS) and educational partners for continuous learning.
Empowering Values: Live by values that prioritize teamwork, growth, and serving others.
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