Director, Payor Contracting

🕒 Abril 21

🌵 Arizona – Remoto

🌵 Arizona – Remote

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

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Healthcare Outcomes Performance Co. (HOPCo)

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

🤝 B2B

☁️ SaaS

💰 Private equity em 2019-02

B2B • SaaS

A Healthcare Outcomes Performance Co. (HOPCo) é a maior organização de cuidados ortopédicos baseados em valor nos EUA, especializada na entrega, gestão e criação de valor em cuidados abrangentes do sistema musculoesquelético (MSK). Liderada por médicos e executivos ortopédicos, a HOPCo opera uma rede clínica integrada de MSK acreditada e oferece soluções de parceria prática e de sistema de saúde, programas de saúde populacional voltados para o pagador e cuidados baseados em valor, análises e relatórios de resultados, e ferramentas digitais de engajamento do paciente para alinhar partes interessadas, melhorar resultados e reduzir os custos totais de MSK.

Descrição

• 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.

🎯 Requisitos

• Bachelor’s Degree in Business, Finance or Healthcare Administration required. • 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. • 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.

🏖️ Benefícios

• Normal office environment • Some travel within community • Requires sitting and standing associated with a normal office environment