Executive Director, Provider Contracting

This is a fully remote position, open to applicants in Illinois, +3 more states.

📋 Description

• Create and oversee contracting strategies for both commercial and governmental networks.

• Formulate, negotiate, and finalize reimbursement contracts.

• Ensure network adequacy for both commercial and governmental networks.

• Build networks, draft reimbursement agreements, and negotiate contracts for hospitals, large professional groups with special pricing, and hospital-based physicians.

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

• Develop strategies and negotiate contracts for newly recognized provider categories.

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

• Address and resolve contractual issues and disputes.

• Oversee management and staff to ensure achievement of goals, training, staffing, and communication.

• Manage budgetary, operational, and financial reporting.

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

• Safeguard the confidentiality of company business.

• Update the Vice President of Network Management on developments.

• Undertake special projects as required or requested.

• Travel as necessary.

⛳️ Requirements

• Bachelor’s degree and 15 years of experience in healthcare/insurance administration, hospital/healthcare contracting, and hospital/physician relations, or 19 years of relevant experience.

• 7 years of management experience.

• Proficient knowledge of hospital and provider reimbursement strategies and policies.

• Excellent verbal and written communication skills, including interpersonal abilities.

• Capability to represent the company to external entities, negotiate contracts, resolve issues, and prepare presentations for executives and staff.

• Strong leadership, teamwork, and relationship-building skills.

• Proven experience in a fast-paced environment and meeting deadlines.

• Ability to work cross-functionally in a highly matrixed setting.

• Accuracy and sound judgment concerning financial matters, such as contract performance and impact.

• Strong negotiation skills.

• Experience in overseeing annual budgets and resource allocation.

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

• Experience in conducting cost-benefit analyses to justify investments and ensure ROI.

• Sponsorship is not available.

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

🏝️ Benefits

• Tailored development plans and professional growth opportunities.

• 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.

• Additional incentives.

• Annual incentive bonus plan.