Director, Payor Contracting

🕒 April 21

🌵 Arizona – Remote

🌵 Arizona – Remote

⏰ Full Time

🔴 Lead

👔 Director

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Healthcare Outcomes Performance Co. (HOPCo)

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🤝 B2B

☁️ SaaS

💰 Private equity on 2019-02

B2B • SaaS

Healthcare Outcomes Performance Co. (HOPCo) is the largest orthopedic value-based care organization in the U. S. , specializing in comprehensive musculoskeletal (MSK) care delivery, management, and value creation. Led by orthopedic physicians and executives, HOPCo operates an accredited MSK clinically integrated network and offers practice partnership and health system solutions, payor-facing population health and value-based care programs, analytics and outcomes reporting, and digital patient engagement tools to align stakeholders, improve outcomes, and lower total MSK costs.

📋 Description

• 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.

🎯 Requirements

• 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.

🏖️ Benefits

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