Director, Contract & Payor Relations / Enterprise Contracting / Full-time / Days

Childrens Hospital Los Angeles • Los Angeles, CA

67d • $122,595 - $210,163

About The Position

This position is responsible for directing and coordinating the managed care policies, goals, and objectives related to contract language, pricing and negotiation strategy, planning and execution, revenue reconciliation as applicable, and payor relationship management on behalf of CHLA, CHLA Medical Group, CHLA Health Network and their subsidiaries as applicable. Will support CHLA Medical Group leadership in working with Physician Organizations in the market regarding managed care contracts, strategies for improving market share and opportunities to collaborate and build relationships with payors. Will also be responsible for collaboration and communication between Enterprise Contracting and other key stakeholder departments within CHLA and CHLA Medical Group, working closely with Decision Support, Patient Financial Services, CHLA, CHLA Medical Group, CHLA Health Network and Pediatric Management Group leadership, clinical departments, HIM, CDM, Admitting and Revenue Cycle leaders. May have direct oversight of staff which may additionally include LOAs, CHLAMG coverage agreements and leases. This position is based in Glendale, California, but will require some travel, approximately 4-5 times a month, to other hospital/medical group/payer offices in addition to meetings held at CHLA.

Requirements

• 10+ years of experience in the healthcare environment.
• 7 years of experience in a managed care position.
• Demonstrated competencies in managed care.

Nice To Haves

• 14+ years of experience in the healthcare environment.
• 10 years of experience in a managed care position.
• Master's degree in a relevant field.

Responsibilities

• Direct and coordinate managed care policies, goals, and objectives.
• Manage contract language, pricing, and negotiation strategy.
• Plan and execute revenue reconciliation as applicable.
• Manage payor relationships on behalf of CHLA and its subsidiaries.
• Support CHLA Medical Group leadership in managed care contracts.
• Collaborate with Physician Organizations regarding market strategies.
• Build relationships with payors to improve market share.
• Facilitate communication between Enterprise Contracting and key departments.
• Oversee staff related to LOAs, coverage agreements, and leases.
• Travel to other hospital/medical group/payer offices as required.

Benefits

• Competitive compensation package.
• Robust benefits program.

What This Job Offers

• Industry: Hospitals
• Education Level: Bachelor's degree