Director Contracting and Payor Relations

Berkshire Health Systems; Pittsfield (MA); On-site; USD 90,000 - 130,000; Full time

Job summary

Berkshire Health Systems is seeking a senior leader to develop and lead managed care initiatives and oversee the contractual terms that affect financial performance across the Health System.

The role requires extensive contract negotiation experience within a managed care environment and a strong background in accounting, finance or business administration.

Qualifications

• 5+ years contract negotiation experience in a managed health care environment.
• Thorough knowledge of the health care market and the needs/concerns of an integrated health care system.
• Proven competence in contract negotiation with large managed care plans.

Responsibilities

• Develop and lead managed care initiatives designed to improve the contractual financial performance of the Health System.
• Oversee the implementation of contractual terms.
• Lead remedial action plans and communicate health plan policies and procedures to BHS internal and external community.

Skills

Contract negotiation

Health care knowledge

Financial analysis

Education

Bachelor's Degree in Accounting, Finance or Business Administration

Master's Degree

Job description

Responsibilities

• Responsible for developing and leading managed care initiatives designed to improve the contractual financial performance of the Health System. Oversees the implementation of contractual terms. Spearheads the development and ongoing monitoring of remedial action plans and oversees communication of health plan policies and procedures to BHS internal and external community.

Position Qualifications

• Experience:
• 5+ years contract negotiation experience in a managed health care environment with a thorough knowledge of the health care market and the needs/concerns of an integrated health care system.
• Education and Training:
• Bachelor's Degree in Accounting, Finance or Business Administration required.
• Master's Degree preferred.
• License, Certification & Registration:
• None.
• Other Requirements:
• Proven competence in contract negotiation with large managed care plans.
• Requires a high level of initiative, sound judgment, and the ability to work independently meeting goals and objectives on time, balancing multiple priorities and utilizing resources appropriately.
• Requires the ability to work with health plans to analyze complex data, identify opportunities for improvement and facilitate resolutions which will have a positive affect on the Health System.
• Requires the ability to understand and interpret all aspects of a contract: financial, legal, and operational.
• Requires the ability to understand the nuances of a health plan's numerous product lines, and the unique operational and financial features associated with each of these products.
• Excellent leadership, communication and organizational skills.
• Must be an accomplished multi-disciplinary team-builder with hands‑on style.
• Must be able to exercise appropriate judgment as necessary and raise issues to the appropriate level.
• Requires strong verbal and written communications skills to effectively communicate both detail and at a summary level to all levels of management.
• Ability to present technical information in a way that establishes rapport, persuades others, and gains understanding.
• Ability to coach/mentor others in the organization on methodologies and tools.
• Excellent team and relationship building skills are essential.
• Requires the ability to independently analyze and resolve complex financial and contractual issues.
• Requires the ability to coordinate efforts amongst various departments at the Health System.