Director of Provider Contracting

Health Care Service Corporation•Albuquerque, NM

About The Position

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for developing and implementing the methodology which results in competitive contract pricing while maintaining a broad network of hospitals, physicians, behavioral health and ancillary providers on a statewide basis. Directing and overseeing management and staff responsible for contracting, provider relations activities, network directories, provider/facility database and reporting. This position collaborates with HCSC Network Management colleagues in the development of Enterprise Network strategies and initiatives.

Requirements

Bachelor Degree and 10 years health care or health insurance experience to include 4 years contract administration and facility or provider relations experience OR 14 years of health care or health insurance experience to include 4 years contract administration and facility or provider relations experience.
4 years management experience including hiring, performance management, change management and professional development.
Reimbursement Methodology expertise
Leadership skills.
Financial acumen, experience with oversight of budget, and experience with financial managed care contracting.
Knowledge of facility/provider contracting methodologies and pricing strategies and the facility or provider community.
Presentation skills.
Negotiation, contracting skills and analytical and strategic thinking skills.
Verbal and written communication skills.

Nice To Haves

Masters Degree.
Experience developing strategies and implementing initiatives.
Experience developing budget.

Responsibilities

Directing and overseeing management and staff responsible for contracting, provider relations activities, network directories, provider/facility database and reporting.
Collaborating with HCSC Network Management colleagues in the development of Enterprise Network strategies and initiatives.
Overseeing the annual budget and allocating resources for various projects and operational needs.
Translating needs and initiatives into compelling business cases.
Conducting cost-benefit analyses to justify investments and ensure ROI.