VP Payer Relations and Contracting
5 - 7 years experience •
Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 12 hospitals, 16 pharmacies, specialty care centers and specialty medical services that provide home care, senior transitions, hospice care, home oxygen and medical equipment, and emergency medical transportation services. Allina Health is a vibrant, growing organization with opportunities to suit your professional skills and a diverse work environment to match your specific interests. We believe employees are our greatest asset and are dedicated to helping you develop and maximize your professional skills.
The Commons, located in Minneapolis, is the headquarters of Allina Health, a not-for-profit health care organization serving patients and communities. Approximately 1,600 corporate and administrative service employees work at offices within Midtown Exchange, the site of the historic Sears retail complex at Chicago Avenue and E. Lake Street. This community landmark, adjacent to the campus of Abbott Northwestern Hospital, part of Allina Health, is the second largest building in Minnesota and includes offices, an internationally themed public market and residential units.
The Vice-President, Payer Contracting will be responsible for planning, directing, and coordinating the policies, goals and objectives related to contract language and rate pricing, negotiation strategy, planning and execution, revenue reconciliation, and payer strategy for the system as directed by the Chief Financial Officer. This position is ideal for a senior leader who is looking for a new challenge that will provide an opportunity to have a positive impact on the profitability and future growth of an organization through the implementation of innovative and best practices related to payer contracting.
- Works closely with Executive Vice President & CFO, other executive and senior leadership to assure financial integrity is achieved and maintained for provider contracts.
- Provides strategic leadership, financial and administrative oversight of payer contracting and operations.
- Leads the design, development, and distribution of database tools and application to efficiently measure, monitor, and/or forecast medical cost structure and performance of payer contracts.
- Develops a Contracting Model.
- Develops and prioritizes target list of payers
- Develops materials for meetings with payers
- Implements and maintains a contract administration system to include tracking of contract negotiation, implementation and renewal processes, billing and collecting related contract payments.
- Builds corporate knowledge of all financial aspects of government program reimbursement methodologies and prevalent reimbursement methodologies.
- Provides input into the budget process. Controls expenses while meeting service requirements.
- Recruits, develops and motivates staff. Initiates and communicates a variety of personnel actions including employment, termination, performance reviews, salary reviews and disciplinary actions.
- Plans, directs, and coordinates contractlanguage, rate pricing, negotiations, revenue reconciliation, and payer relationship management.
- Serves as the resident expert and educator; holds primary responsibility for building expertise in provider contracting.
- Determine reporting and benchmarking reports and audiences.
- Builds strong relationships with key constituents throughout the organization especially with clinical leadership, senior leadership and the finance department.
- Provide innovation, be an industry leader and “raise the bar” in the department.
Key objectives of this position are as follows:
- Build an infrastructure that supports a strong Payer Contracting Department
- Create a Payer strategy for the Health System
- Gain an understanding of the current contracts and close out open negotiations
- Create a partnership culture with Payers
- Lead the movement towards risk based contracting
- Cultivate relationships with government and non-government agencies
- A Bachelor’s degree in relevant and related field; Master’s degreepreferred.
- Five (5) to ten (10) years’ experience in managed care contracting and/or the healthcare industry.
- Strong analytical and problem solving skills.
- Excellent communication and interpersonal skills.
- Proven ability to successfully partner with payers and to collaborate effectively with peers within an organization in order to achieve positive results.
- Significant knowledge of contractual, administrative, health insurance and operational issues related to managed care organizations, physician groups (including physician billing experience), hospitals and health insurance benefit plan design preferred.
- Proven and extensive contracting technical skills; negotiation skills, contract preparation and implementation, financial analysis and rate proposal development, and in depth knowledge of various reimbursement methodologies.
- Experience working in a clinically integrated environment strongly preferred.
- Experience with Risk based contracting strongly preferred.