Description
The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment.
Responsibilities
The Director, Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. This Director will also have oversight and responsibility for provider engagement and provider performance.
Required Qualifications
• Bachelor's Degree
• Extensive provider contracting experience
• Proven leadership experience, including teambuilding
• Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies
• Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
• Master's or J.D. Degree
• Experience with ACO/Risk Contracting
• Value based contracting experience
Additional Information
Must be located in Florida or willing to relocate to Florida.
Scheduled Weekly Hours
40
Job Type: Full time