
Senior Director of Payor Contracting and Negotiations
Nearterm, Aurora, CO, United States
Exceptional Opportunity For a Proven Sr. Director of Payor Relations & Contracting.
Client Offers:
Exceptional Benefits
Team Building
Growth Potential
Scope:
The role manages relationships with payers, lead negotiation,prepartion,documentation and implementation of new and establish contracts for facility and professional agreements with third party payers on of the health system including new programs and services.
Ovesee organizational contract development and management activities and enforce organizational principles of integrity and compliance
Develops standards for contracts, including payment terms, general language and provisions based on strategy discussions, senior management input and organizational needs
Evaluates rate proposals, changes to reimbursement methodologies and conduct related analyses to ensure continued financial viability of the contract
Ensures contracts and proposals are properly entered into organizational databases to measure, track and monitor utilization and financial performance of managed care contracts
Negotiates single case agreements to capture financial reimbursement from non-contracted entities
Serves as primary organizational contact during payer contract negotiations
Assists HPBS Department and internal customers with resolution of complex payer issues. Participate in Leadership meetings with third party payers to address contractual payment issues and trends
Communicates and provides tools for contractual terms to other departments whose functions are necessary to the development, implementation and management of the provider arrangements.
Responsible for the credentialing of Healtcare facilities which includes all associated clinics and new business ventures
Must be strategic and forward thinking and 9 years plus experience
Contracts Negotiations
Managed Care, Medicaid, Medicare and Medicare Advantage contracting
Degree Required:
Must have Masters Degree