HOPCo is the leading provider of musculoskeletal value-based health outcomes, service line and practice management.
Vice President, Payor Contracting
Location
United States
Posted
3 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Vice President, Payor Contracting
Healthcare Outcomes Performance Co. (HOPCo)
Role Description - Develop and maintain positive, effective relationships with internal and external customers and serve as the contracting liaison between contracted Payors and providers. - Lead contract analysis and negotiations with Payors on behalf of providers including rates, payment methodologies, contract language and value-based payment programs in accordance with internal control processes for contract review, approval and signature. - Lead development of Payor reimbursement analyses that can be routinely updated and maintained as a baseline for strategies to maximize health plan reimbursement and ensure payment integrity. - Research and make recommendations to executive leadership in regard to payor contracting opportunities in new and existing geographic service area. - Ensure compliance in all business and contractual relationships. - Identify and communicate trends and/or potential issues to market leadership and HOPCo management team. - Lead development of infrastructure and analysis for strategic projects including rate transparency, payment validation and coordination with Revenue Cycle Management, payor contracting strategy including value based care glidepath. - Other duties and responsibilities as assigned. - The job holder must demonstrate current competencies for job position. Qualifications - Bachelor’s Degree in Business, Mathematics, Finance or Healthcare Administration required. - Proven working knowledge of provider financial issues, complex contracting options, financial/contracting arrangements and regulatory requirements. - 7-10 years related experience and comprehensive level of analytic and negotiating skills with successful track record supporting contract negotiations with payors. - Strong communication, critical thinking, problem resolution and interpersonal skills. - Solid understanding of industry dynamics required. Requirements - Familiarity with managed care products and services, medical cost trend analysis, including analysis of physician contracts, utilization, and costs. - Must have prior experience working with managed care contracting modeling. - Familiar with a variety of concepts, practices, and procedures in the field of managed care. - Must be able to problem solve and come forward with recommendations. - Must be able to stay on task with minimal supervision. - Excellent critical thinking, troubleshooting, and analytical skills. Knowledge - Knowledge of payor reimbursement. - Managed care contracting. - Market and industry knowledge. Skills - Strong verbal and written communication skills. - Strong organizational skills and careful attention to detail. - Advanced computer skills. Abilities - Ability to analyze problems and interpret information. - Able to prioritize and reprioritize, as necessary. - Ability to work independently, and as part of a team. - Ability to multi-task, manage multiple projects, and meet tight deadlines. Environmental Working Conditions - Normal office environment or Remote. - Some travel within community. Physical/Mental Demands - Requires sitting and standing associated with a normal office environment. - Some bending and stretching required. - Manual dexterity using a calculator and computer keyboard. Organizational Requirements - HOPCo Mission, Vision and Values must be acknowledged and adhered to. - OSHA Requirements and training to include: Safety Training.
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