Director-Network Contract Management

Independent Health; United States; Hybrid; USD 150,000 - 190,000; Full time

Job summary

Independent Health in Williamsville, NY, is seeking a Director of Network Contract Management to coordinate contracting strategy across facilities and providers. The role leads negotiations, reimbursement development and analytics, ensuring alignment with organizational goals.

Responsibilities include managing provider contracts, developing reimbursement methodologies, and guiding staff. Hybrid onsite work at Williamsville, with a focus on strategic market outcomes and cross-functional

Qualifications

• Bachelor’s degree required.
• Master’s degree preferred.
• Eight (8) years of network contract or practice management administrative experience.
• Four (4) years of management experience.
• Knowledge of the healthcare industry pertaining to facilities, physician and ancillary providers.
• Ability to align provider contractual agreements with senior leadership goals.
• Proficient in Excel; experience with SAS, SQL Developer, and Python.
• Strong facilitation, team leadership and communication skills.
• Ability to deliver data-driven analyses and stay within priorities.

Responsibilities

• Develop strategic compensation and contracting strategy with facility providers.
• Serve as lead contract negotiator, with direction from the CFO.
• Provide contract management for all facility provider contracts.
• Research and develop reimbursement methodologies for facility providers.
• Manage reimbursement, analytics, operational and relationship issues with facility providers.
• Identify reimbursement trends from government programs and private payers.
• Integrate new reimbursement methods within system configurations and fee schedules.
• Present results to CFO and executive team; support decision-making.
• Manage staff across provider contracts and agreements.

Skills

Contract negotiation

Staff leadership

Strategic contracting

Data analysis

Excel

SAS

SQL Developer

Python

Communication

Healthcare industry knowledge

Education

Bachelor’s degree

Master’s degree

Four years of experience in lieu of degree

Tools

SAS

SQL Developer

Python

Excel

Job description

FIND YOUR FUTURE

We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.

Overview

The Director-Network Contract Management will work with the Chief Financial Officer, or their designee, to coordinate the overall contracting strategy on a cross functional basis including but not limited to Health Care Services, Finance, System Configuration, Product Development and Network Contract Management. The Director will manage and lead negotiation, reimbursement development, analytics, contracting and operational aspects of all facility health care provider contracts. They will also be responsible for leading staff in the development and risk assessment of reimbursement methodologies to ensure that reimbursement is aligned with the strategic and operating objectives of the organization. The Director-Network Contract Management will manage contracting issues for all facility provider contracts. This will include but is not limited to all contracts, rate amendments and addendums. They will collaborate with other leaders in the organization to ensure that all facility rate agreements are accurately and efficiently implemented. The Director-Network Contract Management shall be responsible for managing all operational and relationship issues with all hospitals, free standing ambulatory surgery centers, skilled nursing facilities and other ancillary providers as appropriate and will manage and train staff as it relates to reimbursement, analytics, contractual, operational and relationship issues with these same provider types.

Qualifications

• Bachelor’s degree required.
• Master’s degree preferred.
• An additional four (4) years of experience will be considered in lieu of degree.
• Eight (8) years of network contract or practice management administrative experience required.
• Four (4) years of management experience required.
• Knowledge of the healthcare industry as it pertains to facilities, physician and ancillary providers.
• Ability to think strategically to align provider contractual agreements and relationships with the goals and objectives of senior leadership. This will include but is not limited to reimbursement, medical resource management, network development and product development.
• Knowledge of reimbursement methodologies, contractual agreements and operational issues and the ability to work with and develop staff in these key core process areas.
• Proficient in the use of analytical tools including Excel (required), and programming application languages including but not limited to SAS, SQL Developer, and Python (preferred).
• Strong facilitation, team leadership and management skills.
• Ability to access and deliver timely, accurate and relevant data and information.
• Excellent communication skills.
• Ability to concisely and logically present complex issues verbally and in writing, to interact effectively at all levels, and to listen carefully.
• Effectively handle diverse assignments under shifting priorities and tight timeframes.
• Comprehensive understanding of internal and external environmental influences.
• Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Essential Accountabilities

Work to develop strategic compensation and contracting strategy with facility providers. This will include but is not limited to consultation with Population Health and Care Management, Finance, System Configuration, Product Development and Network Contract Management. Serve as a lead contract negotiator, with direction from the Chief Financial Officer, or their designee. Provide contract management for all facility provider contracts. Responsible for the research and development of reimbursement methodologies for all facility providers. Manage contracting issues for all providers. This will include but is not limited to all contracts, rate amendments and addendums. Manage all reimbursement, analytical, operational and relationship issues with all facility providers. Identify emerging trends in reimbursement by government (e.g. CMS and NYSDOH) and private payers. Identify requirements applicable to Independent Health lines of business and emerging opportunities for better alignment of public/private programs. Manage and lead the integration of new and existing reimbursement methods within existing system configurations, fee schedules, claims processing attributes, provider contracts and in accordance with Independent Health strategic objectives. Make recommendations and present results to assist in the decision-making process of the Chief Financial Officer or their designee and the rest of the Executive Team as necessary. Manage network reimbursement, analytical, operational and contracting staff to support the negotiation and or renegotiation of hospital, free standing ambulatory surgery center, skilled nursing facilities, and other applicable ancillary provider agreements.

This is a hybrid position with onsite attendance required at our Williamsville location.

Immigration or work visa sponsorship will not be provided for this position.

Compensation Range: $150,000 - $190,000 annually. Compensation may vary based on factors including but not limited to skills, education, location and experience. In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Aff... Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.

We are committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. An applicant for employment in need of an accommodation to participate in the application and recruitment process should contact Human Resources at: [e-mail] or Human Resources, 511 Farber Lakes Drive, Williamsville, NY 14221.

The Independent Health Family of Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in their health and well-being.

Established in 1980, our comprehensive portfolio includes Pharmacy Benefit Dimensions, Reliance Rx, Nova Healthcare Administrators, Care for You and the Independent Health Foundation.

Our culture sets us apart. Our core values drive who we are and the work we do. As a member of our family, you're part of something special, in your work and in the community. We understand and appreciate that everyone has unique experiences, perspectives and identities which is why we pledge to create a safe space where all people and ideas are welcomed. We are here to continue learning and to generate important dialog. We are committed to doing what matters most - reaching out, working together, and caring for our community. A healthy community benefits everyone who lives in it. You too can be part of making difference in the lives of others, together we achieve so much more.