Strategic Director, Provider Contracting (Remote)

HCSC Group; Northern (KY); Hybrid; USD 121,000 - 225,000; Full time

Benefits offered by this job

Remote work within continental US

Total rewards package

Job summary

Health Care Service Corporation (HCSC) is seeking a Director of Provider Contracting to lead contracting strategies for commercial and government networks. This remote role involves negotiating reimbursement contracts for hospitals and large groups, ensuring network adequacy, and overseeing contracting operations with a focus on ROI and compliance.

The position requires a Bachelor's degree plus five years in hospital contracting, five years of management experience, and strong negotiation and

Qualifications

• Bachelor's degree plus 5 years' experience in hospital/health care contracting or hospital/physician relations.
• 5 years management experience.
• Experience with large integrated health care delivery systems and complex reimbursement strategies.
• Experience proactively developing and maintaining relationships with health care provider leadership teams.
• Knowledge of outpatient and provider reimbursement strategies and policies.

Responsibilities

• Develop and manage contracting strategies for operations relative to commercial and government networks.
• Accountable for the development, negotiation, and successful completion of reimbursement contracts.
• Ensure network adequacy for commercial and government networks.
• Develop network, draft reimbursement agreements, and negotiate contracts for hospitals and large professional groups.
• Achieve competitive discounts and access through contract negotiations and relationship management.
• Develop strategies, draft agreements, and negotiate contracts for newly recognized categories of providers.
• Oversee analysis and reporting required to develop reimbursement strategies and take corrective action as needed.
• Resolve issues and contractual disputes.
• Ensure staff meet goals, are trained, and communications are effective.
• Manage budget and financial reporting.
• Communicate professionally with leadership, coworkers, and customers.
• Comply with HIPAA and corporate policies throughout.

Skills

Negotiation

Leadership

Communication

Travel readiness

Cross-functional collaboration

Education

Bachelor's degree in hospital/health care contracting

Job description

Health Care Service Corporation (HCSC) is seeking a Director of Provider Contracting to lead contracting strategies for commercial and government networks. This remote role involves negotiating reimbursement contracts for hospitals and large groups, ensuring network adequacy, and overseeing contracting operations with a focus on ROI and compliance.

The position requires a Bachelor's degree plus five years in hospital contracting, five years of management experience, and strong negotiation and