DIRECTOR, CONTRACTING (CALIFORNIA)

AMSURG

43d • Remote

About The Position

The Director, HPR Relations is responsible for securing and maintaining optimal reimbursement rates with health plan partners. Responsibilities include ensuring that the needs of facilities / entities, health plans and AmSurg are met by achieving annual assigned pipeline goals while establishing and maintaining positive business relationships.

The ideal candidate for this position will be located in California area of the United States.

Requirements

• Strong negotiating skills with national/regional payors
• Solid understanding of payer contract language and multiple payment methodologies
• Ability to build relationships with providers, external vendors/payers and employees at all levels in the organization
• Strong organizational and written/verbal communication skills
• Excellent ability to manage to deadlines
• Demonstrated proficiency with financial reports, utilization trends, and patient mix based upon analysis of the data being tracked
• Experience working in a matrix environment where multiple and competing customer demands are likely
• Ability to work independently and with little supervision
• Ability to positively handle conflict
• Self-directed with a strong bias for action and urgency
• Experience working with health plans
• Must be fluent in Microsoft Office applications
• Bachelor’s degree with an emphasis in finance, accounting, or healthcare administration
• Six to ten years relevant experience in health care including managed care contracting, payment methodologies, contract language, contract negotiations and financial analysis

Nice To Haves

• Preferred experience: Project management, medical group operations, health plan operations, financial reporting and value-based contracting

Responsibilities

• Negotiate initial or renewal contractual terms and reimbursement with designated market payers
• Manage multiple concurrent negotiation activities while leveraging strong project management skills to drive progress on specific market strategies to optimize reimbursement
• Create and maintain relationships between AmSurg providers and payers related to contracting
• Facilitate updating and maintenance of consolidated contract management system for accurate tracking of reimbursement terms and conditions.
• Establish regular communication and strong inter-Company relationships, while monitoring payer issues as they relate to provider participation, contract loading, payment issues in conjunction with Revenue Cycle team
• Assist in the development of departmental goals, executing projects to achieve these goals, and working closely with others within the HPR Department to continuously monitor Department performance
• Onboard acquisitions and new entities / locations to payer contracts as requested.
• Develop reports and presentations by collecting, analyzing and summarizing information and trends
• In collaboration with Vice President, analyze contract performance data, conduct onsite visits with payers, clients and centers that require market specific strategies.
• Ability to work in a matrix environment where multiple and competing customer demands are likely.
• Facilitate internal training or educational tools as they related to health plan contracting
• Position requires overnight travel up to 25% of the time
• Other Duties as assigned

Benefits

• AMSURG offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. Benefits offered include but are not limited to: Paid Time Off, Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs, and a matching 401(K) Plan.
• AMSURG offers paid time off, 9 observed holidays, and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.

What This Job Offers

• Job Type: Full-time
• Career Level: Director