Candidates must be local to Philadelphia, PA.
Reporting to the AVP, Government & Payer Strategy, the Director will oversee the payer contracting and support the payer strategy functions for the Health System. The Director will continuously assess and refine the Health System's payer contracts which will encompass all third party plans including Commercial, Medical Assistance, Medicare Advantage, Workers Compensation, International care via Philadelphia International Medicine, and any other payer arrangement. Additionally the Director will include any CMS or Commonwealth based programs beyond the traditional FFS programs such as those originating in CMMI. The Director is the primary contact with health insurers for the development of new products, promotion of Health System services, contracting issues and pricing. Develops and maintains third party payer agreements with health system member institutions and affiliates to optimize revenue. The Director will coordinate the contracting aspect for the Temple Care Clinically Integrated Network (TempleCare CIN) network management functions and payer contracting.
Education
Master's Degree Required or
Combination of relevant education and experience may be considered in lieu of degree Required
Experience
10+ years experience in a related position including 5 years of performance driven contracts
and ACO/CIN agreements Required
7 years experience in a healthcare provider environment Required
General Experience in managed care contracting Required
Licenses
