Hybrid Director, Provider Contracting

at Health Care Service Corporation

• Job title: Director, Provider Contracting
• Job type: Full Time
• Experience level: Lead
• Salary: $118,800 - $220,800 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Chicago, United States

About the role

• Director of Provider Contracting overseeing negotiations and partnerships in the health care sector. Managing contracts and relationships to enhance provider networks and performance metrics in a hybrid work environment.

Responsibilities

• Responsibility over MA National Risk partnerships, including CareAllies, encompassing contracting, partner retention, operations, growth, financial and quality performance and strategic planning.
• Achieve competitive advantage in discounts and access through contract negotiations and effective relationship management.
• Coordinate contracting with staff who may report directly to other Directors and Managers within Network Management, as needed.
• Oversee the analysis and reporting required to develop reimbursement strategies and take corrective action as needed
• Oversee the performance of negotiated health care provider compensation and appropriate reimbursement of medical costs
• Analyze monthly activity reports, budget and variance reports and formulate resolutions for problem trends.
• Identify deficiencies in reporting capabilities and coordinate development and implementation of needed methodologies.
• Develop, implement and maintain processes and standards for provider network expansion, contracting and servicing. Ensure that quality standards regarding the provider network are met.
• Directly manage staff including but not limited to: hiring, performance management, talent management, training, counseling, pay administration and change management.
• Assist in presentations to existing and potential customers.

Requirements

• Bachelor’s degree plus 5 years’ experience in hospital/health care contracting, and hospital/physician relations
• 5 years management experience
• Experience working with large integrated health care delivery systems and complex reimbursement strategies
• Experience proactively developing and maintaining relationships with health care provider leadership teams with propensity to build trust
• Knowledge of outpatient and provider reimbursement strategies and policies
• Experience with financial matters such as contract performance and impact including accuracy and sound judgment
• Experience proactively developing creative, win-win solutions considering the impact on the provider contract, network, marketability of the product, and profitability of the product
• Negotiation skills
• Leadership skills
• Team player/relationship oriented
• Clear and concise verbal and written communications skills including interpersonal skills, presentation skills to present to executives internally and externally, and team building
• Experience meeting deadlines and work well under pressure
• Experience working across departments to accomplish initiatives and goals, building consensus, driving initiatives, gaining support and developing workable solutions
• Ability and willingness to travel, including overnight stays
• Overseeing the annual budget and allocating resources for various projects and operational needs.
• Translating needs and initiatives into compelling business cases.
• Conducting cost-benefit analyses to justify investments and ensure ROI.

Benefits

• health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement
• other incentives