Senior Director – Payer Contracting

🕒 il y a 29 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🟠 Senior

👔 Directeur

🦅 Parrain de Visa H1B

Cette entreprise a parrainé des visas H1B par le passé.

👻 Score fantôme 15%

Ce que ça veut dire : la probabilité que personne ne recrute vraiment pour cette offre.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Cleveland Clinic

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10 000+ employés

🏥 Santé

⚕️ Assurance santé

🧘 Bien-être

Healthcare • Healthcare Insurance • Wellness

La Cleveland Clinic, située à Cleveland, Ohio, est un centre médical universitaire pluridisciplinaire à but non lucratif qui intègre les soins cliniques et hospitaliers avec la recherche et l'éducation.

Description

• Develop and execute payer strategies reflecting market position, financial goals, reimbursement priorities, growth objectives, and organizational risk tolerance • Lead high-stakes negotiations and renegotiations with market and national health plans across fee-for-service and advanced value-based arrangements • Structure and negotiate shared-savings, downside-risk, percent-of-premium, full-risk, transplant, high-cost drug, and provider-payer product agreements • Own the contracting life cycle from strategy and modeling through negotiation, implementation, performance monitoring, renewal, and escalation • Build analytic frameworks evaluating reimbursement, contract yield, utilization, total cost of care, quality performance, attribution, risk adjustment, and financial exposure • Lead, coach, and develop contracting professionals and analysts • Influence clinical, financial, legal, operational, and executive stakeholders to resolve competing priorities and achieve enterprise-wide outcomes • Strengthen payer accountability and executive relationships while identifying opportunities for market growth and innovative partnerships • Perform other duties as assigned

🎯 Exigences

• Bachelor's degree in business, marketing, or health care related field • Ten years of managed care experience in a payer or provider organization • Five years of advanced value-based care or risk-based percent of premium management and negotiating experience in a payer or provider setting • Demonstrated success leading complex payer negotiations with significant financial, operational, and market implications • Deep knowledge of reimbursement methodologies, contract analytics, value-based payment models, risk structures, managed care policy, and relevant legal and regulatory considerations • Proven ability to lead teams and influence senior stakeholders in fluid, highly matrixed environments • Ability to communicate and exchange accurate information • Ability to perform work in a stationary position for extended periods • Ability to work with physical records or operate a computer or other office equipment • In some locations, ability to travel throughout the hospital system • In some locations, ability to move up to 25 lbs. • Follow standard precautions using personal protective equipment as required for procedures • Employment offers are followed by testing for controlled substances • Must comply with Cleveland Clinic Health System's influenza prevention program, including annual vaccination or an approved exemption

🏖️ Avantages

• Annual influenza vaccination or approved exemption under the influenza prevention program • Drug-free work environment • Equal employment opportunity

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