Director, Payor Relations

Cook Children's Health Care System; Fort Worth (TX); On-site; USD 110,000 - 150,000; Full time

Job summary

Cook Children's Health Care System in Fort Worth seeks a Director of Payor Relations to oversee relationships with managed care organizations. The role involves securing and managing contract negotiations and addressing contract-related issues, requiring 10+ years of relevant operational experience.

The ideal candidate will foster effective communication and possess superior problem-solving and presentation skills. A bachelor's degree is preferred. Join us for an impactful role dedicated to pediatric health care.

Qualifications

• Bachelor's degree preferred.
• 10+ years of operational experience in a managed care setting.
• Extensive experience in contract negotiation and payor relations.
• Superior knowledge of medical terminology.
• Detail-oriented with strong verbal and written communication skills.
• High level of problem-solving and presentation skills.
• Ability to work independently and supervise staff.

Responsibilities

• Develop and maintain relationships with managed care organizations.
• Secure, manage, and renegotiate health care service contracts.
• Oversee contract implementation and validation.
• Address contract-related claims issues.

Skills

Contract negotiation

Payor relations

Verbal communication

Written communication

Problem solving

Presentation skills

Education

Bachelor's degree

Job description

Location: Calmont Operations Building

Department: Payor Relations

Shift: First Shift (United States of America)

Standard Weekly Hours: 40

Summary

The Director of Payor Relations is responsible for developing and maintaining meaningful and effective relationships with managed care organizations and internal staff with the goal of securing, managing, and renegotiating viable, revenue‑generating health care service contracts on behalf of CCHCS entities and providers with both commercial and government‑funded managed care organizations. The Director will manage payor intelligence, contract implementation and validation as well as oversee issues and follow up on contract related claims issues.

Qualifications

• Bachelor's degree preferred.
• At least ten (10) years of operational experience in a managed care setting required.
• Extensive experience in contract negotiation and payor relations required.
• Superior knowledge of medical terminology.
• Must be able to foster and maintain healthy relationships with outside payors. Must have a clear understanding of the intricacies of commercial, state and federal government‑funded insurances.
• Must be detail oriented with a high level of verbal and written communication skills.
• Must have high level of problem solving and presentation skills.
• Must be able to work independently, effectively supervise staff and actively participate as an integrated team member.

About Us

Cook Children's Health Care System offers a unique approach to caring for children because we are one of the country's leading integrated pediatric health care delivery organizations. Patients benefit from the integrated system because it allows Cook Children's to use all of its resources to treat a patient and allows for easy communication between the various companies by physicians with a focus on caring for children and adolescents.

Cook Children's is an equal opportunity employer. As such, Cook Children's offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement, and termination.