Director of Provider Contracting

Health Care Service Corp.; Albuquerque (NM); On-site; USD 121,200 - 225,200; Full time

Job summary

Health Care Service Corp. seeks a candidate in Albuquerque, New Mexico, responsible for developing competitive contract pricing methodologies and overseeing provider relations. You'll manage a team and collaborate on Enterprise Network strategies.

Required qualifications include a Bachelor’s Degree with 10 years of relevant health care or health insurance experience and 4 years in management. The position offers a competitive salary range of $121,200 to $225,200 based on experience.

Qualifications

• 10 years of health care or health insurance experience.
• 4 years of management experience, including hiring and performance management.
• Expertise in reimbursement methodology.

Responsibilities

• Develop and implement competitive contract pricing methodology.
• Oversee provider relations activities and network directories.
• Collaborate on Enterprise Network strategies and initiatives.

Skills

Health care or health insurance experience

Management experience

Reimbursement methodology expertise

Financial acumen

Negotiation and contracting skills

Education

Bachelor’s Degree

Master’s Degree (preferred)

Job description

Job Summary

This position is responsible for developing and implementing the methodology that results in competitive contract pricing while maintaining a broad network of hospitals, physicians, behavioral health and ancillary providers on a statewide basis. The role directs and oversees management and staff responsible for contracting, provider relations activities, network directories, provider/facility database, and reporting. It collaborates with HCSC Network Management colleagues in the development of Enterprise Network strategies and initiatives.

Qualifications (Required)

• Bachelor’s Degree and 10 years of health care or health insurance experience, including 4 years of contract administration and facility or provider relations experience, OR 14 years of health care or health insurance experience, including 4 years of contract administration and facility or provider relations experience.
• 4 years of management experience, including hiring, performance management, change management and professional development.
• Reimbursement methodology expertise.
• Leadership skills.
• Financial acumen, experience with oversight of budget, and experience with financial managed care contracting.
• Knowledge of facility/provider contracting methodologies and pricing strategies and the facility or provider community.
• Presentation skills.
• Negotiation, contracting skills and analytical and strategic thinking skills.
• Verbal and written communication skills.
• Overseeing the annual budget and allocating resources for various projects and operational needs.
• Translating needs and initiatives into compelling business cases.
• Conducting cost-benefit analyses to justify investments and ensure ROI.

Preferred Qualifications

• Master’s Degree.
• Experience developing strategies and implementing initiatives.
• Experience developing budget.

Compensation

Base Pay Range: $121,200.00 - $225,200.00. Exact compensation may vary based on skills, experience, and location.

Employment Statement

HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.