Dir, Payor Relations & Conract

Less than 5 years experience  •  Healthcare IT

Salary depends on experience
Posted on 11/28/17
Less than 5 years experience
Healthcare IT
Salary depends on experience
Posted on 11/28/17

Job Summary:  Responsible for strengthening the Pinnacle Health System's (PHS) position in the evolving managed care market by working within the context of PHS's mission to implement PHS's managed care strategies and related operational support systems.

Job Requirements:  Graduate of an accepted graduate level program in Healthcare, Business or Public Administration (preferred).   A minimum of three years experience in a healthcare delivery setting specific to planning, healthcare administration and managed care.  Good oral and written communication skills required. Must possess analytical, problem solving and decision making skills.  Must be tactful, diplomatic and able to communicate convincingly on all levels.

Primary Responsibilities:

Contract Negotiation and Management:

-       Increase revenue via the negotiation of contracts with managed care organizations (MCOs) and payors on behalf of the PHS hospitals, home health, hospice, ambulance, behavioral health, continuous care nursing, and physician services.

-       Assist with the design, development, management, and/or implementation of performance value based and narrow network arrangements with strategic payor partners.

-       Act as liaison with administrators and department heads regarding terms of managed care contracts during the negotiation process.

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