Vice President Payor Contracting - Managed Care

Tower Health; West Reading (Berks County); On-site; USD 120,000 - 200,000; Full time

Job summary

Tower Health is looking for a Vice President of Payor Contracting to lead contract negotiations and manage payor relationships. This strategic role includes planning and directing policies related to contracting and financial practices.

The ideal candidate has a Bachelor's Degree, extensive experience in negotiating payor contracts, and a proven track record of building and maintaining successful relationships within healthcare networks.

Join Tower Health, a leading healthcare system in Berks County, offering innovative and compassionate healthcare services.

Qualifications

• Relevant experience managing payor relationships and leading negotiations.
• Expertise in payors and managed care to inform decision making and operational improvements.
• Proven strength in building and maintaining strong relationships internally and externally with key constituents.

Responsibilities

• Planning, directing, and coordinating contract language and rate pricing.
• Develops materials for meetings with payors.
• Leads the movement towards risk-based contracting.

Skills

Excellent Communication

Interpersonal Skills

Financial and Business Acumen

Strategic Thinking

Negotiation Skills

Analytical Skills

Leadership Skills

Collaborative Skills

Strong Team Player

Delegation Skills

Detail Oriented

Computer skills including Microsoft Office applications

Organizational Skills

Presentation Skills

Service Orientation

Accountable for maintaining workplace safety

Education

Bachelor's Degree

Job description

Job Summary

In this impactful role, the Vice President of Payor Contracting is responsible for planning, directing, and coordinating the policies, goals and objectives related to contract language and rate pricing, negotiation strategy, planning and execution, revenue reconciliation, and payor strategy for the system.

• Gains an understanding of the current contracts and closes out open negotiations.
• Plans, directs, and coordinates contract language, rate pricing, negotiations, revenue reconciliation, and payor relationship management.
• Builds an infrastructure that supports a strong payor contracting department.
• Provides strategic leadership, financial and administrative oversight of payor contracting and operations.
• Creates a partnership culture with payors.
• Builds strong relationships with key constituents throughout the organization especially with clinical leadership, senior leadership, and the Finance department.
• Collaborates with system leadership to assure financial integrity is achieved and maintained for provider contracts.
• Develops a Contracting Model and a payor strategy for the Health System.
• Develops materials for meetings with payors.
• Builds corporate knowledge of all financial aspects of government program reimbursement methodologies and prevalent reimbursement methodologies.
• Determines reporting and benchmarking reports and audiences.
• Leads the movement towards risk-based contracting.

Qualifications

Experience

• Relevant experience managing payor relationships and leading negotiations
• Expertise in payors and managed care to inform decision making and operational improvements
• Proven strength in building and maintaining strong relationships internally and externally with key constituents

Education Requirements

• Bachelor's Degree
• Completes and maintains all competencies and trainings as required for role.

Required Skills

• Excellent Communication, Interpersonal, and Listening Skills
• Financial and Business Acumen
• Strategic Thinking
• Negotiation Skills
• Analytical Skills
• Leadership Skills
• Collaborative Skills
• Strong Team Player
• Delegation Skills
• Detail Oriented
• Computer skills including Microsoft Office applications
• Organizational Skills
• Presentation Skills
• Service Orientation
• Accountable for maintaining workplace safety

About the Employer

Tower Health is a regional integrated healthcare system that offers leading-edge, compassionate healthcare and wellness services to communities in Berks, Chester, Montgomery, and Philadelphia Counties. With 1,200 beds across the system, Tower Health consists of Reading Hospital in West Reading; Phoenixville Hospital in Phoenixville; Pottstown Hospital in Pottstown; and St. Christopher's Hospital for Children, a partnership of Tower Health and Drexel University in Philadelphia. For more information, please visit https://towerhealth.org.

Overview

Discover why our hospital is a great place to work—take a virtual tour of Reading Hospital here: https://youtu.be/hH6ItnuIIsc