Remote Exec Dir, Provider Contracting & Network Strategy

Health Care Service Corporation; Chicago (IL); On-site; USD 162,000 - 300,000; Full time

Job summary

Health Care Service Corporation is seeking a senior network contracting leader to develop and manage contracting strategies for commercial and government networks. You will oversee negotiation of reimbursement contracts, ensure network adequacy, and manage staff responsible for contracting operations.

You will analyze provider compensation programs, drive cost-effective reimbursement strategies, and lead cross-functional teams in a matrixed environment while ensuring HIPAA and compliance

Qualifications

• Bachelor degree and 15 years experience in health care/insurance administration, hospital/health care contracting, and hospital/physician relations or 19 years experience.
• 7 years management experience.
• Knowledge of hospital and provider reimbursement strategies and policies.
• Clear and concise verbal and written communications and interpersonal skills for negotiations and presentations.
• Leadership, team player, and relationship-building abilities.
• Experience in fast-paced environments with deadlines.
• Ability to work cross-functionally in a highly matrixed environment.
• Accuracy and sound judgment on financial matters such as contract performance and ROI.
• Negotiation skills and ability to resolve issues and disputes.
• Overseeing annual budget and allocating resources for projects.
• Translating needs into compelling business cases and cost-benefit analyses.

Responsibilities

• Develop and manage contracting strategies for operations relative to commercial and government networks.
• Accountable for development, negotiation, and completion of reimbursement contracts; ensure network adequacy.
• Draft reimbursement agreements and negotiate contracts for hospitals, large professional groups with special pricing, and hospital-based physicians.
• Achieve competitive advantage in discounts and access through contract negotiations and relationship management.
• Develop strategies, draft agreements, and negotiate contracts for newly recognized provider categories.
• Oversee analysis and reporting to develop reimbursement strategies and take corrective action as needed.
• Accountable for resolution of issues and contractual disputes.
• Ensure staff meets goals, is trained, positions filled, and communications on changes are provided.
• Accountable for budget, operational and financial reporting.
• Communicate effectively with colleagues, management, and customers.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable policies.
• Maintain complete confidentiality of company-related business.
• Maintain effective communication with Vice President, Network Management and perform special projects as required.

Skills

Leadership skills

Negotiation skills

Verbal and written communication

Cross-functional collaboration

Budgeting and financial oversight

Education

Bachelor degree

MBA or Masters in Health Administration

Job description

Health Care Service Corporation is seeking a senior network contracting leader to develop and manage contracting strategies for commercial and government networks. You will oversee negotiation of reimbursement contracts, ensure network adequacy, and manage staff responsible for contracting operations.

You will analyze provider compensation programs, drive cost-effective reimbursement strategies, and lead cross-functional teams in a matrixed environment while ensuring HIPAA and compliance