[Hiring] Manager Physician Contracting @company

Role Description

This position plans, directs and controls the contracting activities related to all professional (e.g., physician, dentist and non-physician including but not limited to psychologist, LCSW, podiatrist, audiologist etc.) and assigned ancillary (e.g., Homecare agency) services to assure that the Corporations act as prudent purchasers of services. This role is responsible for establishing and implementing corporate physician, non-physician and assigned ancillary contracting strategy, and developing and maintaining related contracting policies, practices, and standards across regions. Additionally, this position works with key stakeholders to ensure optimum contracting results and relations with the integrated hospital and physician entities in the region.

• Develops and implements reimbursement and negotiation strategies for all professional and assigned ancillary service providers.
• Establishes appropriate pricing and reimbursement strategies for professional and assigned ancillary service providers.
• Oversees and coordinates annual community fee schedule updates.
• Analyzes network needs for the professional and assigned ancillary networks.
• Independently leads negotiations with professional and assigned ancillary provider types.
• Leads preparation and execution of legal contract templates and amendments.
• Leads evaluation and resolution process for professional and assigned ancillary contractual disputes and disagreements.
• Develops, maintains, and enhances processes for contract management functions.
• Represents contracting during budget discussions and tracking for professional and assigned ancillary providers.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Maintains knowledge of all relevant legislative and regulatory mandates.
• Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.

Qualifications

• Bachelor’s Degree in business, healthcare, finance, or relevant field required. Master’s Degree preferred.
• Minimum of 2-5 years’ experience in leadership of people or projects.
• Minimum of 2-5 years’ experience in finance, actuarial, and/or negotiations.
• Excellent communication and negotiation skills.
• Ability to work constructively with external contacts including hospital administrators, owners of provider companies, physicians, provider organization leaders, and other providers of health and health-related services and equipment.
• Current and thorough understanding of health care, financial models, physician organizations, contracts, and the Corporations’ products.

Requirements

• Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time.
• Ability to travel across the Health Plan service region for meetings and/or trainings as needed.

Benefits

• Participation in group health and/or dental insurance.
• Retirement plan.
• Wellness program.
• Paid time away from work.
• Paid holidays.

Compensation Range(s)

Grade E7: Minimum $87,766 - Maximum $157,978. The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity.

Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.