Regional Director of Payer Strategies

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🔥 0 minutes ago

🌾 Iowa – Remote

🌾 Iowa – Remote

💵 $176.6k - $291.4k / year

⏰ Full Time

🔴 Lead

👔 Director

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Trinity Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

📚 Education

🤝 Non-profit

Healthcare • Education • Non-profit

Trinity Health is a Christian K-12 educational institution located in Wichita, Kansas, dedicated to providing a Christ-centered education that nurtures spiritual growth and academic excellence. The academy emphasizes the importance of faith in students' lives, integrating spiritual development with rigorous academic programs and a broad array of extracurricular activities, including athletics and fine arts. Trinity Health fosters a supportive community where teachers and families collaborate to help students develop a personal relationship with Jesus Christ and excel in their studies.

📋 Description

• Develop and execute managed care and commercial payer strategies with regional CFOs and CEOs. • Negotiate regional managed care and commercial payer contracts using consistent language and reimbursement methodologies. • Align contracts with regional health ministry strategies. • Maintain relationships with hospital, Revenue Excellence, System Office, Legal, and payer senior leadership. • Operationalize and implement managed care contracts and updates at hospitals and within Revenue Excellence. • Monitor programs, denial management, payer compliance, and payer financial and operational performance. • Communicate and implement payer policy changes and provide additional training when needed. • Identify payer collaboration opportunities and implement collaborative programs. • Serve as liaison between hospitals and regional payers. • Provide regular payer reporting packages, including payer report cards, to hospital C-suite and Revenue Excellence leaders. • Develop and maintain market profiles of key payers, buyers, and brokers. • Develop, implement, and monitor payer pay-for-performance initiatives. • Work with hospital clinical leadership to maximize revenue realization. • Manage and mentor regional payer contracting staff. • Prepare budgets and manage resources within budget targets. • Maintain compliance with applicable laws, regulations, Trinity Health policies, and the Code of Conduct.

🎯 Requirements

• Comprehensive knowledge of healthcare finance, managed care, and insurer contracting. • Bachelor’s degree in Business Administration normally required. • Eight to ten years of healthcare experience, including significant experience working with managed care and other payers. • Master’s in Business Administration or Master’s in Health Administration preferred. • Professional certification such as FHFMA, FACHE, or FAHM preferred. • Proven contract negotiation knowledge and skills. • Strong analytical skills. • Strong written and verbal communication skills. • Ability to operate effectively in a collaborative, shared leadership environment. • Personal presence characterized by honesty, integrity, and caring, with the ability to inspire and motivate others. • Working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Integrity and Compliance Program, Code of Conduct, policies, and procedures.

🏖️ Benefits

• Remote work arrangement • Equal Opportunity Employer