Title: Director Provider Contracting
Location: Houston, TX
Travel: 10%

JOB SUMMARY:

• 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.

MINIMUM QUALIFICATIONS:

• 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)

Other Requirements:

• 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.