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Director, PRS GMC Exchange

Ascension

United States

Remote

USD 80,000 - 120,000

Full time

11 days ago

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Job summary

Ascension is seeking a professional for the Payor Contracting and Relation department. This full-time role involves negotiating contracts, managing teams, and developing healthcare solutions for better reimbursement models. Candidates should possess strong negotiation skills and experience in managed care or contracting while being part of a mission-driven organization dedicated to transforming healthcare.

Benefits

Paid time off (PTO)
Various health insurance options
Retirement benefits with employer match
Long-term & short-term disability
Employee assistance programs (EAP)
Tuition reimbursement
Benefits for military families

Qualifications

  • High School diploma with 5 years experience or Associate's degree with 3 years experience.
  • Leadership experience required, specifically in managed care or contracting.
  • Strong negotiation and relationship-building skills within healthcare.

Responsibilities

  • Negotiate payer contracts and direct financial modeling for contracting.
  • Lead development of value-based health contracts and reimbursement models.
  • Educate internal teams on changes in reimbursement methodologies.

Skills

Negotiation skills
Team leadership
Interpersonal skills
Organizational skills

Education

High School diploma or Associate's/Bachelor's degree

Tools

Google Suite

Job description

We Are Hiring
  • Department:Payor Contracting and Relation
  • Schedule: Full-time, 8 hour day shift, Monday - Friday, Remote
  • Facility: Ascension
What You Will Do

Negotiate and review payer and direct employer contracts for the organization.

  • Direct analysts in financial modeling specific to contracting efforts, ensuring negotiated outcomes meet desired objectives.
  • Lead the development and contracting for value-based population health opportunities and new reimbursement models. Contracts include fee-for-service.
  • Responsible for educating ministries on impact of changes in reimbursement methodology imposed by commercial payers and governmental agencies.
  • Serve as a liaison between payers and ministry departments, hosting routine meetings with payers to resolve outstanding issues.
  • Develop reports and reporting solutions specific to payer relations, managed care and contracting needs.
What You Will Need

Education:

  • High School diploma equivalency with 5 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management OR Associate's degree/Bachelor's degree with 3 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management.
Additional Preferences

Additional Preferences:

  • 5 years of managed care or contracting, including experience with provider relations, network development, and/or contract management, required.
  • 5 years of direct contract red line experience, required.
  • 5 years of proven negotiation skills and the ability to build strong relations with various health-careproviders, preferred.
  • 5 years of federal and state legislative environments, regulatory processes, and government health-careprograms (e.g., Medicare, Medicaid) is required.
  • Strong experience leading and managing teams, required.
  • Strong Google Suite Professional experience, required.
  • Strong organizational skills a must have.
  • Strong interpersonal skills a must have

#LI-Remote

Why Join Our Team

Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters.

Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.

Equal Employment Opportunity Employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.

For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

Pay Non-Discrimination Notice

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

E-Verify Statement

This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.E-Verify

Benefits

Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer.

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