Director, Provider Contracting

Altais • Remote - CA, CA

3d

About The Position

About Altais: At Altais, we’re on a mission to improve the healthcare experience for everyone—starting with the people who deliver it. We believe physicians should spend more time with patients and less time on administrative tasks. Through smarter technology, purpose-built tools, and a team-based model of care, we help doctors do what they do best: care for people. Altais includes a network of physician-led organizations across California, including Brown & Toland Physicians, Altais Medical Group Riverside, and Family Care Specialists. Together, we’re building a stronger, more connected healthcare system. About the Role Are you looking to join a fast-growing, dynamic team? We’re a collaborative, purpose-driven group that’s passionate about transforming healthcare from the inside out. At Altais, we support one another, adapt quickly, and work with integrity as we build a better experience for physicians and their patients. The Director, Contracting is responsible for developing, maintaining and expanding strategic relationships in multiple geographies with hospitals, physicians, ancillary and behavioral health providers. This will consist of managing, negotiating and executing contracts with the various provider types listed as well as implementation of such contracts all in pursuit of achieving the overall company strategy goals and initiatives. Additionally, this role will be responsible for leading a team with direct reports. You will focus on: Identify, develop, and implement corporate contracting strategies, business opportunities, and methodologies for contract negotiations, stabilizing health care costs and/or decrease expenses to remain within company budget Develop and maintain strong working relationships with key hospitals and network providers Manages complex contracting and negotiations for fee for service and value-based reimbursements with network providers (e.g. Hospital systems, ancillaries, and large physician groups) Performs analysis independently and coordinates with the Finance Division to review financial performance and healthcare costs of provider contracts Lead complex contract implementations as well as identify and resolve issues around contracts Creates and manages value-based contracting incentives and reimbursement methodologies that are quality and performance based Leads in resolving elevated and complex contractual issues with internal and/or external customers Participate in external provider meetings and internal operational meetings to continuously improve relationships, processes, operations and best practices Oversees the development of accurate and timely internal communication around new and renewed managed care arrangements Develop, evaluate, and interpret contract language terms to ensure language is consistent with company policies and applicable regulatory agencies Oversight of all contract template revisions, partnering with Compliance and Legal to ensure templates are up to date Creates and oversees all departmental and organization resource material applicable to Provider Contracting, i.e. Policies and Procedures, Provider Manual Responsible for training contracting team on operational changes, department updates and upcoming projects

Requirements

• Bachelor's degree from accredited 4-year university or equivalent coursework or equivalent experience in managed healthcare related field.
• 10+ years professional managed healthcare administration experience
• 5+ years people management experience in healthcare / contracting related positions
• Experience working in IPA / managed care setting
• Strong financial acumen with proficiency in analyzing and interpreting financial trends
• Proven contract preparation skills, with an in-depth knowledge of Medicare, Medi-Cal, PPO, HMO Commercial lines of business, various reimbursement methodologies and value-based contracting

Nice To Haves

• Master's preferred.

Responsibilities

• Identify, develop, and implement corporate contracting strategies, business opportunities, and methodologies for contract negotiations, stabilizing health care costs and/or decrease expenses to remain within company budget
• Develop and maintain strong working relationships with key hospitals and network providers
• Manages complex contracting and negotiations for fee for service and value-based reimbursements with network providers (e.g. Hospital systems, ancillaries, and large physician groups)
• Performs analysis independently and coordinates with the Finance Division to review financial performance and healthcare costs of provider contracts
• Lead complex contract implementations as well as identify and resolve issues around contracts
• Creates and manages value-based contracting incentives and reimbursement methodologies that are quality and performance based
• Leads in resolving elevated and complex contractual issues with internal and/or external customers
• Participate in external provider meetings and internal operational meetings to continuously improve relationships, processes, operations and best practices
• Oversees the development of accurate and timely internal communication around new and renewed managed care arrangements
• Develop, evaluate, and interpret contract language terms to ensure language is consistent with company policies and applicable regulatory agencies
• Oversight of all contract template revisions, partnering with Compliance and Legal to ensure templates are up to date
• Creates and oversees all departmental and organization resource material applicable to Provider Contracting, i.e. Policies and Procedures, Provider Manual
• Responsible for training contracting team on operational changes, department updates and upcoming projects

Benefits

• Excellent medical, vision, and dental coverage
• 401k savings plan with a company match
• Flexible time off and 9 Paid Holidays
• This position will also be eligible to participate in our annual bonus program

What This Job Offers

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