Titre: Director Provider Contracting
Localisation: Houston, TX
Voyage:% 10
RÉSUMÉ DE L'EMPLOI:
- The Director provides strategic leadership in the development, direction, execution, and evaluation of an effective contracting program.
- The Director is responsible for assuring the program supports the delivery of quality providers appropriately and effectively, and that meets all contractual and regulatory requirements.
- This position develops and maintains a robust provider network that meets state-defined accessibility standards and incorporates continuous quality improvement and effective outreach programming.
- In addition, the Director develops systems to ensure effective coordination between network providers and contracting and ensures the analysis of utilization and cost data is translated to program implementation.
- Assures that network and contracting function are aligned with organizational strategic objectives and financial targets.
QUALIFICATIONS MINIMALES:
- Education/Specialized Training/Licensure:
BA/BS; 4 years equivalent work experience may substitute for degree requirement.
Work Experience (Years and Area):
- 7 years in healthcare, with at least 5 years’ experience in Providers/Managed Care Contracting.
- Health Plan experience preferred.
- Must have medical contract negotiations experience, preferably in Houston market.
Management Experience (Years and Area):
- 4 years’ direct supervision experience required
Software Operated:
- Office (Word, Excel, Outlook)
Autres exigences:
- Must have car and valid Texas Driver’s license.
- Contracting experience with both hospital and physician practice (group practice and solo practitioner) required.
- Skilled at developing and implementing strategic objectives for the contracting function.
- Experience with implementing provider incentive programs and pay-for-quality programs.
- Experience with claims payment and CRM systems required.
- Demonstrated ability to manage and develop staff in medical contract negotiation.