Director, Provider Contracting

This is a fully remote position, open to applicants in Illinois, +5 more states.

📋 Description

• Formulate and oversee contracting strategies for both commercial and government networks.

• Create, negotiate, and finalize reimbursement contracts.

• Ensure sufficient network adequacy for commercial and government networks.

• Draft reimbursement agreements and negotiate contracts with hospitals, large professional groups that require specialized pricing, and hospital-based physicians.

• Attain a competitive edge in discounts and access through effective contract negotiations and relationship management.

• Develop strategies and negotiate contracts for newly recognized categories of providers.

• Supervise analysis and reporting for reimbursement strategies and implement corrective actions as necessary.

• Address issues and resolve contractual disputes.

• Oversee staff, ensuring that objectives are met, positions are filled, training is conducted, and communication is maintained.

• Manage the budget, operational reporting, and financial reporting.

• Communicate effectively with colleagues, management, customers, and leadership.

• Adhere to HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other relevant policies.

• Maintain the confidentiality of company business information.

• Undertake special projects as required or requested.

• Travel as necessary, including overnight stays.

⛳️ Requirements

• Bachelor’s degree along with 5 years of experience in hospital/healthcare contracting or hospital/physician relations.

• 5 years of management experience.

• Experience with large integrated healthcare delivery systems and intricate reimbursement strategies.

• Proven ability to proactively develop and sustain relationships with healthcare provider leadership teams.

• Knowledge of outpatient and provider reimbursement strategies and policies.

• Background in financial matters related to contract performance and its impact.

• Experience in creating innovative, mutually beneficial solutions involving provider contracts, networks, marketability, and profitability.

• Strong negotiation skills.

• Effective leadership skills.

• Clear and concise verbal and written communication abilities, including interpersonal, presentation, and team-building skills.

• Capability to meet deadlines and perform well under pressure.

• Experience collaborating across departments to achieve initiatives and goals, build consensus, drive projects, gain support, and develop viable solutions.

• Willingness and ability to travel, including overnight stays.

• Experience in overseeing budgets and allocating resources effectively.

• Ability to articulate needs and initiatives into persuasive business cases.

• Proficient in conducting cost-benefit analyses to justify investments and ensure return on investment (ROI).

• Remote employees are required to reside within the continental United States, excluding Alaska, California, Hawaii, or New York.

• Sponsorship is not available.

🏝️ Benefits

• Tailored development plans and opportunities for professional growth.

• Comprehensive health and wellness benefits.

• 401(k) savings plan.

• Pension plan.

• Paid time off.

• Paid parental leave.

• Disability insurance.

• Supplemental life insurance.

• Employee assistance program.

• Paid holidays.

• Tuition reimbursement.

• Annual incentive bonus plan.

• Additional incentives.