Director, Payor Contracting

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Build and sustain positive, effective relationships with both internal and external customers, acting as the contracting liaison between contracted Payors and providers.

• Perform contract analysis and negotiations with Payors on behalf of providers, covering aspects such as rates, payment methodologies, contract language, and value-based payment programs, adhering to internal control processes for contract review, approval, and signature.

• Engage in Payor reimbursement analysis that can be regularly updated and maintained as a foundational strategy to enhance health plan reimbursement.

• Investigate and provide recommendations to executive leadership regarding payor contracting opportunities within new and existing geographic service areas.

• Ensure compliance across all business and contractual relationships.

• Identify and relay trends and/or potential issues to the management team.

• Additional duties and responsibilities as assigned.

⛳️ Requirements

• A Bachelor’s Degree in Business, Finance, or Healthcare Administration is required.

• Demonstrated knowledge of provider financial issues, complex contracting options, financial/contracting arrangements, and regulatory requirements.

• 5-7 years of relevant experience and a comprehensive level of negotiating skills with a proven track record of successful contract negotiations with payors.

• Familiarity with managed care products and services, as well as medical cost trend analysis, including the evaluation of physician contracts, utilization, and costs.

• Previous experience with managed care contracting modeling is essential.

• Knowledgeable in a variety of concepts, practices, and procedures within the managed care field.

• Capable of problem-solving and providing actionable recommendations.

• Ability to remain focused and productive with minimal supervision.

• Exceptional critical thinking, troubleshooting, and analytical skills.

🏝️ Benefits

• Normal office environment

• Some travel within the community

• Requires sitting and standing associated with a normal office environment