Executive Director, Provider Contracting

🕒 September 2

🌽 Illinois, Oklahoma, +2 more states – Remote

🌽 Illinois – Remote 🌪️ Oklahoma – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote

💵 $161.5k - $299.7k / year

⏰ Full Time

🔴 Lead

👔 Director

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Develop and manage contracting strategies for commercial and government networks • Develop, negotiate, and complete reimbursement contracts • Ensure network adequacy for commercial and government networks • Develop networks, draft reimbursement agreements, and negotiate contracts for hospitals, large professional groups with special pricing, and hospital-based physicians • Achieve competitive advantage in discounts and access through contract negotiations and relationship management • Develop strategies and negotiate contracts for newly recognized provider categories • Oversee analysis and reporting for reimbursement strategies and take corrective action as needed • Resolve contractual issues and disputes • Oversee management and staff, ensuring goals, training, staffing, and communications • Manage budget, operational reporting, and financial reporting • Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and applicable policies • Maintain confidentiality of company business • Communicate developments to the Vice President, Network Management • Perform special projects as required or requested • Travel as needed

🎯 Requirements

• Bachelor degree and 15 years experience in health care/insurance administration, hospital/health care contracting, and hospital/physician relations OR 19 years experience in those areas • 7 years management experience • Knowledge of hospital and provider reimbursement strategies and policies • Clear and concise verbal and written communication skills, including interpersonal skills • Ability to represent the company to external entities, negotiate contracts, resolve issues, and prepare executive and employee presentations • Leadership, team player, and relationship-building skills • Experience working in a fast-paced environment and meeting deadlines • Ability to work cross-functionally across a highly matrixed environment • Accuracy and sound judgment regarding financial matters such as contract performance and impact • Negotiation skills • Experience overseeing annual budgets and allocating resources • Ability to translate needs and initiatives into compelling business cases • Experience conducting cost-benefit analyses to justify investments and ensure ROI • Sponsorship is not available • Remote employees must live within the continental United States, excluding Alaska, California, Hawaii, or New York

🏖️ Benefits

• Curated development plans and professional development • 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 • Annual incentive bonus plan