Confidential Asheville, NC, USA
Apr 27, 2018Full time
Local practice management company seeking to hire position of Director, Managed Care Contracting. Responsibilities include performing financial analysis, evaluate contract terms and fee schedules, and conduct negotiations. Position requires ability to understand financial modeling, the ability to analyze rate proposals, contract terms and negotiate contract terms and communicate effectively with a variety of stakeholders. The position also serves as a resource and liaison to implement and resolve payment issues related to existing managed care contracts. This is a highly visible, results-oriented position within the practice. DUTIES AND RESPONSIBILITES: Oversees the sourcing, negotiation, implementation, monitoring, and management of all payer agreements including conducting periodic audits for payer compliance. Responsible for strategic planning, accountability for other reimbursement and subcontract arrangements including government programs. Actively facilitates timely review and renegotiation/renewal of all managed care contracts with emphasis on improving fees. Works closely with the physicians in the practice on all contracting initiatives including communications on status of contracting efforts. Responsible for setting the strategic direction for the department, including a plan for systematically evaluating fees, identifying high target opportunities. Works with other areas to develop outcomes reporting and communicating value proposition on new clinical initiatives to payers. Maintains database of care contracts, terms, and fee schedules. Evaluates all markets for most appropriate contracting strategy. Reviews all payer contracts; identifies areas/language of potential risk; recommends and negotiates more favorable terms on behalf of the practice physicians. Quantifies and communicates specific results of negotiating efforts. Ability to build and maintain positive relationships with representatives of managed care companies. Demonstrates professionalism and promotes positive interpersonal relations with all internal and external business contacts, representing corporation in a positive manner, displaying personal commitment to achieving the goals and objectives of the corporation. The position oversees small staff of contracting specialist and support personnel. Job Requirements Undergraduate degree required Masters preferred. Five years in healthcare or managed care industry preferred. Significant knowledge in contract negotiations, understanding of insurance and operational issues related to managed care organizations and/or physician groups is preferred. Excellent communication skills, both written and oral are required. Proficient personal computer skills, including Microsoft Excel, Word and Outlook. Centricity Practice Management experience a plus. Must have ability to communicate professionally and effectively across the entire organization.