Director of Contracting for Managed Care




Job Number:
5389 DG
Location:
Utah, Texas
Compensation:
$150,000 - $165,000
Relocation:
Yes
Travel:
N/A
Contact:
David Goldie
dgoldie@marvelconsultants.com
P: 216-455-1424
(800) 338-1257

 

 

Function


Director of Contracting for Managed Care

Under the direct supervision of the SVP, UT Operations and Managed Care, position will work closely with senior leadership to negotiate reimbursement rates, legal terms, performance programs, and risk arrangements with managed care plans for hospitals, physicians, and ancillary providers. Develops, manages, and sustains relationship with members of physician network with contracted managed care payers. Serves as a resource for the market leadership team, answering questions and providing information about network procedures or contracts. Reviews billings and claims payments according to managed care contracts.

 

Requirements


  • Demonstrated strong knowledge in developing and assessing risk and FFS reimbursement models.
  • Understanding of the health care delivery setting including both hospital and physician reimbursement and claims processing.
  • Develops, manages, and sustains relationship with brokers and employers to ensure the network has access to increased patients through aligned payer partners.
  • Serves as executive team member to partner with payers to target key employers for open enrollment opportunities and maintains a pipeline of opportunities for each hospital.

Please reference Job Code 5389 DG when responding to this position. Please send your resume as an attached document in Word form

Our Partners