Director, Payor Contracting

🕒 vor 1 Monat

🌵 Arizona – Remote

🌵 Arizona – Remote

⏰ Vollzeit

🔴 Experte

👔 Direktor

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Healthcare Outcomes Performance Co. (HOPCo)

WebsiteLinkedInAlle Stellen

1001 - 5000 Mitarbeiter

🤝 B2B

☁️ SaaS

💰 Private equity im 2019-02

B2B • SaaS

Healthcare Outcomes Performance Co. (HOPCo) ist die größte orthopädische Organisation für wertorientierte Versorgung in den USA und spezialisiert sich auf umfassende muskoskeletale (MSK) Versorgung, Management und Wertschöpfung. Geleitet von Orthopäden und Führungskräften betreibt HOPCo ein akkreditiertes, klinisch integriertes MSK-Netzwerk und bietet Praxispartnerschaften sowie Lösungen für Gesundheitssysteme, bevölkerungsbezogene Gesundheits- und wertorientierte Versorgungsprogramme für Kostenträger, Analysen und Ergebnisberichte sowie digitale Patientenbindungstools an, um Interessengruppen zu vereinen, Ergebnisse zu verbessern und Gesamtkosten der MSK-Versorgung zu senken.

Beschreibung

• 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.

🎯 Anforderungen

• 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.

🏖️ Vorteile

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