Director-Network Contract Management

Independent Health Association•Buffalo, NY

3d•Hybrid

About The Position

The Director-Network Contract Management will work with the Chief Financial Officer, or their designee, to coordinate the overall contracting strategy on a cross functional basis including but not limited to Health Care Services, Finance, System Configuration, Product Development and Network Contract Management. The Director will manage and lead negotiation, reimbursement development, analytics, contracting and operational aspects of all facility health care provider contracts. They will also be responsible for leading staff in the development and risk assessment of reimbursement methodologies to ensure that reimbursement is aligned with the strategic and operating objectives of the organization. The Director-Network Contract Management will manage contracting issues for all facility provider contracts. This will include but is not limited to all contracts, rate amendments and addendums. They will collaborate with other leaders in the organization to ensure that all facility rate agreements are accurately and efficiently implemented. The Director-Network Contract Management shall be responsible for managing all operational and relationship issues with all hospitals, free standing ambulatory surgery centers, skilled nursing facilities and other ancillary providers as appropriate and will manage and train staff as it relates to reimbursement, analytics, contractual, operational and relationship issues with these same provider types.

Requirements

Bachelor’s degree required. Master’s degree preferred. An additional four (4) years of experience will be considered in lieu of degree.
Eight (8) years of network contract or practice management administrative experience required.
Four (4) years of management experience required.
Knowledge of the healthcare industry as it pertains to facilities, physician and ancillary providers.
Ability to think strategically to align provider contractual agreements and relationships with the goals and objectives of senior leadership. This will include but is not limited to reimbursement, medical resource management, network development and product development.
Knowledge of reimbursement methodologies, contractual agreements and operational issues and the ability to work with and develop staff in these key core process areas.
Proficient in the use of analytical tools including Excel (required), and programming application languages including but not limited to SAS, SQL Developer, and Python (preferred).
Strong facilitation, team leadership and management skills.
Ability to access and deliver timely, accurate and relevant data and information.
Excellent communication skills.
Ability to concisely and logically present complex issues verbally and in writing, to interact effectively at all levels, and to listen carefully.
Effectively handle diverse assignments under shifting priorities and tight timeframes.
Comprehensive understanding of internal and external environmental influences.
Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Nice To Haves

Master’s degree preferred.
programming application languages including but not limited to SAS, SQL Developer, and Python (preferred).

Responsibilities

Work to develop strategic compensation and contracting strategy with facility providers.
Serve as a lead contract negotiator, with direction from the Chief Financial Officer, or their designee.
Provide contract management for all facility provider contracts.
Responsible for the research and development of reimbursement methodologies for all facility providers.
Manage contracting issues for all providers. This will include but is not limited to all contracts, rate amendments and addendums.
Manage all reimbursement, analytical, operational and relationship issues with all facility providers.
Identify emerging trends in reimbursement by government (e.g. CMS and NYSDOH) and private payers.
Identify requirements applicable to Independent Health lines of business and emerging opportunities for better alignment of public/private programs.
Manage and lead the integration of new and existing reimbursement methods within existing system configurations, fee schedules, claims processing attributes, provider contracts and in accordance with Independent Health strategic objectives.
Make recommendations and present results to assist in the decision-making process of the Chief Financial Officer or their designee and the rest of the Executive Team as necessary.
Manage network reimbursement, analytical, operational and contracting staff to support the negotiation and or renegotiation of hospital, free standing ambulatory surgery center, skilled nursing facilities, and other applicable ancillary provider agreements.