Director, Provider Contracting

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🕒 Maio 9

🏄 California – Remoto

🏄 California – Remote

💵 $154.500 - $185.400 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

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Altais

SiteLinkedInTodas as Vagas

201 - 500 funcionários

Fundada em 2019

👥 B2C

🧘 Bem-estar

B2C • Wellness

A Altais é uma rede de provedores de saúde com sede na Califórnia que unifica várias marcas médicas para oferecer cuidados primários coordenados, atendimento de urgência, serviços especializados, hospitais e laboratórios, além de saúde mental e para idosos em todo o Norte e Sul da Califórnia. A organização apoia médicos e equipes de atendimento com portais de pacientes habilitados por tecnologia e parcerias de cuidados baseados em valor, atendendo pacientes diretamente enquanto trabalha com provedores e parceiros para melhorar o acesso, a acessibilidade e a coordenação do atendimento.

Descrição

• Develop, maintain and expand strategic relationships in multiple geographies with hospitals, physicians, ancillary and behavioral health providers • Manage, negotiate and execute contracts with various provider types as well as implementation of such contracts • Identify, develop, and implement corporate contracting strategies and business opportunities • Develop and maintain strong working relationships with key hospitals and network providers • Manage complex contracting and negotiations for fee for service and value-based reimbursements • Perform analysis independently and coordinate with the Finance Division to review financial performance and healthcare costs of provider contracts • Lead complex contract implementations and identify and resolve issues around contracts • Create and manage value-based contracting incentives and reimbursement methodologies that are quality and performance based • Lead in resolving elevated and complex contractual issues with internal and/or external customers • Participate in external provider meetings and internal operational meetings to continuously improve relationships, processes, operations and best practices • Oversee the development of accurate and timely internal communication around new and renewed managed care arrangements • Develop, evaluate, and interpret contract language terms to ensure consistency with company policies and applicable regulatory agencies • Oversee all contract template revisions, partnering with Compliance and Legal to ensure templates are up to date • Create and oversee all departmental and organization resource material applicable to Provider Contracting • Responsible for training contracting team on operational changes, department updates and upcoming projects

🎯 Requisitos

• Bachelor's degree from accredited 4-year university or equivalent coursework or equivalent experience in managed healthcare related field • 10+ years professional managed healthcare administration experience • 5+ years people management experience in healthcare / contracting related positions • Experience working in IPA / managed care setting • Strong financial acumen with proficiency in analyzing and interpreting financial trends • Proven contract preparation skills, with in-depth knowledge of Medicare, Medi-Cal, PPO, HMO Commercial lines of business, various reimbursement methodologies and value-based contracting

🏖️ Benefícios

• Excellent medical, vision, and dental coverage • 401k savings plan with a company match • Flexible time off and 9 Paid Holidays • Annual bonus program