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Supporting physicians and care teams to deliver exceptional, compassionate, and affordable care.
Director, Provider Contracting
Location
California
Posted
70 days ago
Salary
$154.5K - $185.4K / year
Seniority
Lead
Job Description
Director, Provider Contracting
Altais
• Develop, maintain and expand strategic relationships in multiple geographies with hospitals, physicians, ancillary and behavioral health providers • Manage, negotiate and execute contracts with various provider types as well as implementation of such contracts • Identify, develop, and implement corporate contracting strategies and business opportunities • Develop and maintain strong working relationships with key hospitals and network providers • Manage complex contracting and negotiations for fee for service and value-based reimbursements • Perform analysis independently and coordinate with the Finance Division to review financial performance and healthcare costs of provider contracts • Lead complex contract implementations and identify and resolve issues around contracts • Create and manage value-based contracting incentives and reimbursement methodologies that are quality and performance based • Lead in resolving elevated and complex contractual issues with internal and/or external customers • Participate in external provider meetings and internal operational meetings to continuously improve relationships, processes, operations and best practices • Oversee the development of accurate and timely internal communication around new and renewed managed care arrangements • Develop, evaluate, and interpret contract language terms to ensure consistency with company policies and applicable regulatory agencies • Oversee all contract template revisions, partnering with Compliance and Legal to ensure templates are up to date • Create and oversee all departmental and organization resource material applicable to Provider Contracting • Responsible for training contracting team on operational changes, department updates and upcoming projects
Job Requirements
- Bachelor's degree from accredited 4-year university or equivalent coursework or equivalent experience in managed healthcare related field
- 10+ years professional managed healthcare administration experience
- 5+ years people management experience in healthcare / contracting related positions
- Experience working in IPA / managed care setting
- Strong financial acumen with proficiency in analyzing and interpreting financial trends
- Proven contract preparation skills, with in-depth knowledge of Medicare, Medi-Cal, PPO, HMO Commercial lines of business, various reimbursement methodologies and value-based contracting
Benefits
- Excellent medical, vision, and dental coverage
- 401k savings plan with a company match
- Flexible time off and 9 Paid Holidays
- Annual bonus program
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