Director, Provider Contracting

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🕒 vor 1 Monat

🏄 California – Remote

🏄 California – Remote

💵 $154.500 - $185.400 / Jahr

⏰ Vollzeit

🔴 Experte

👔 Direktor

Jetzt Bewerben

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Altais

WebsiteLinkedInAlle Stellen

201 - 500 Mitarbeiter

Gegründet 2019

👥 B2C

🧘 Wellness

B2C • Wellness

Altais ist ein in Kalifornien ansässiges Netzwerk von Gesundheitsdienstleistern, das mehrere medizinische Marken vereint, um koordinierte primäre Gesundheitsversorgung, Notfallversorgung, spezialisierte Dienste, Krankenhäuser und Labore sowie psychische und Seniorenpflege in Nord- und Südkalifornien anzubieten. Die Organisation unterstützt Ärzte und Pflegeteams mit technologiegestützten Patientenportalen und wertorientierten Partnerschaften im Gesundheitswesen und bedient Patienten direkt, während sie gleichzeitig mit Anbietern und Partnern zusammenarbeitet, um den Zugang, die Erschwinglichkeit und die Koordination der Versorgung zu verbessern.

Beschreibung

• 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

🎯 Anforderungen

• 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

🏖️ Vorteile

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