Dir Provider Contracting at Cambia Health Solutions in Salt Lake City, UT
The Director Provider Contracting leads the provider network strategy and contracting team for a large state or across multiple states. Directs the implementation of the network strategy through contracting, negotiation, and administration of provider and facility agreements for physicians, physician groups, healthcare institutions and ancillary services. Cultivates and maintains relationships with key providers and promotes innovative products and reimbursement methodologies. General Functions and Outcomes Leads state-wide or multi-state contracting strategy efforts and partners with leaders across the organization to ensure alignment with broader business strategies and key initiatives. Ensures contracting staff develops strong partnerships across the provider community and promotes positive working relationships with all types of Cambia providers including physicians, physician groups, ancillary specialty providers, hospitals, institutions, etc. Collaborates with the Actuarial Team to ensure analytical resources effectively support contracting efforts and pricing considerations. Ensures provider feedback, competitive information, health care delivery trends and other metrics are incorporated into contracting strategies and financial models. Manages the contracting team including hiring, performance management, development and retention. Develops strategies along with Vice President of Network Management to ensure unit cost targets and cost stewardship goals are met. Regularly communicates organizational objectives and team goals. Monitors results and metrics to ensure individual and team deliverables are met. Directs execution of contracting and reimbursement strategy and ensures contractual methodology is in accordance with organization objectives, legal, and regulatory requirements. May manage related functions, strategic initiatives, and/or best practice development. Provides support (within and outside the organization) when the VP of Network Management is unavailable. Minimum Requirements Demonstrated success in negotiating contracts and managing relationships with large, complex hospitals, provider groups, and integrated delivery systems. Strong understanding of managed care and accountable health systems models and relationships to contracting strategy and reimbursement methodology. Analytical expertise and ability to interpret complex data for effective decision making. Includes understanding and competency related to health care funding mechanisms, quality and utilization data. Strong communication and facilitation skills with all levels of leadership, including the ability to identify and resolve issues and build consensus among groups of diverse stakeholders. Ability to develop and lead a team including:
hiring, goal setting, coaching and development. Demonstrated competency in resource and project management:
budgeting, organizing work, providing leadership to staff, establishing measures for success, and managing to deliverables. Ability to work in high-pressure circumstances and effectively manage conflict and ambiguity. Normally to be proficient in the competencies listed above:
Director Provider Contracting would have a Bachelor's Degree in healthcare, business or a related field (Masters preferred), 10 years' experience in healthcare provider contracting, 3 years leading others, or equivalent combination of education and experience. FTEs Supervised 5-10 Work Environment Work is primarily performed in an office environment Travel may be required, either locally or out of state Must be able to provide own transportation.
Salary Range:
$200K -- $250K
Minimum Qualification
Allied Health Professionals, Healthcare ManagementEstimated Salary: $20 to $28 per hour based on qualifications.
hiring, goal setting, coaching and development. Demonstrated competency in resource and project management:
budgeting, organizing work, providing leadership to staff, establishing measures for success, and managing to deliverables. Ability to work in high-pressure circumstances and effectively manage conflict and ambiguity. Normally to be proficient in the competencies listed above:
Director Provider Contracting would have a Bachelor's Degree in healthcare, business or a related field (Masters preferred), 10 years' experience in healthcare provider contracting, 3 years leading others, or equivalent combination of education and experience. FTEs Supervised 5-10 Work Environment Work is primarily performed in an office environment Travel may be required, either locally or out of state Must be able to provide own transportation.
Salary Range:
$200K -- $250K
Minimum Qualification
Allied Health Professionals, Healthcare ManagementEstimated Salary: $20 to $28 per hour based on qualifications.
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