Executive Director, Provider Contracting- Work from home

Health Care Service Corporation•National, NV

5d•$161,500 - $299,700•Remote

About The Position

This position is responsible for developing and managing network strategies, drafting contracts, negotiating reimbursement contracts, and servicing hospitals, ancillary providers, and professional providers for commercial and government networks. It ensures contracted network coverage and oversees the management and staff responsible for contracting operations. The role is accountable for analyzing and delivering outcomes for provider compensation programs across commercial and government networks. The position requires the ability and willingness to travel. This is a remote role. Remote employees must live within the continental United States, excluding Alaska, California, Hawaii, and New York. Sponsorship is not available.

Requirements

Bachelor's degree and 15 years of experience in health care/insurance administration, hospital/health care contracting, and hospital/physician relations; alternatively, 19 years of experience in those fields without the stated degree requirement.
Seven years of management experience.
Knowledge of hospital and provider reimbursement strategies and policies.
Clear and concise verbal and written communication skills, including interpersonal skills to represent the company to external entities, negotiate contracts, resolve issues, and prepare executive and employee presentations.
Leadership, teamwork, and relationship-building skills.
Experience working in a fast-paced environment and meeting deadlines.
Ability to work cross-functionally in a highly matrixed environment.
Accuracy and sound judgment regarding financial matters, including contract performance and impact.
Negotiation skills.
Ability and willingness to travel.
Must reside in the continental United States, excluding Alaska, California, Hawaii, and New York.
Sponsorship is not available.

Nice To Haves

MBA or master's degree in Health Administration.

Responsibilities

Develop and manage contracting strategies for commercial and government network operations.
Develop, negotiate, and successfully complete reimbursement contracts, ensuring network adequacy for commercial and government networks.
Develop networks, draft reimbursement agreements, and negotiate contracts for hospitals, large professional groups with special pricing, and hospital-based physicians.
Achieve competitive discounts and provider access through contract negotiations and effective relationship management.
Develop strategies, draft agreements, and negotiate contracts for newly recognized provider categories.
Oversee analysis and reporting used to develop reimbursement strategies and take corrective action as needed.
Resolve issues and contractual disputes.
Ensure staff meet or exceed goals, objectives, and initiatives; ensure staff are trained, positions are filled, and employees receive communications about changes.
Manage the budget, operational reporting, and financial reporting.
Communicate and interact effectively and professionally with coworkers, management, customers, and others.
Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other applicable corporate and departmental policies.
Maintain complete confidentiality of company-related business.
Communicate developments in assigned areas of responsibility to the Vice President, Network Management and perform special projects as required or requested.
Oversee the annual budget and allocate resources for projects and operational needs.
Translate needs and initiatives into business cases.
Conduct cost-benefit analyses to justify investments and ensure return on investment.