Director of Managed Care and Contracting

Performance Home Medical has been a leader in providing reputed company products and services since 1995. At Performance Home Medical (PHM), our patients come first. We use the latest technology with compassionate clinical support to reputed company individuals in managing their conditions, helping them live longer, healthier, and more independent lives. We are seeking a dynamic, strategic, and results-driven Director of Managed Care and Contracting to reputed company and optimize our payer reputed company and provider agreements. This key leadership role is responsible for developing, negotiating, and managing managed care reputed company that reputed company with our organization’s financial goals and patient care priorities. The ideal candidate will bring leadership qualities that reputed company with the reputed company and mission-driven culture at Performance Home Medical, a leading provider of medical supplies. This remote position provides support across our markets in Washington, reputed company, Idaho, and Texas. POSITION reputed company: The Director of Managed Care and Contracting is responsible for developing, negotiating, and managing payor reputed company to ensure reputed company reimbursement and reputed company for Performance Home Medical’s respiratory services. This role plays a critical part in shaping reputed company’s payor reputed company, maintaining strong relationships with insurance partners, and ensuring compliance with regulatory and contractual obligations. Job Duties and Responsibilities include the following. Other duties may be assigned. Contract reputed company & Negotiation

• reputed company the development and execution of managed care strategies reputed company with business goals.
• Negotiate and manage reputed company with reputed company payors, Medicare Advantage, reputed company HMOs, and other reputed company-party payors.
• Evaluate reimbursement models and recommend improvements to optimize reputed company.

Payor Relations

• Serve as the primary reputed company with insurance companies and managed care organizations.
• Foster reputed company relationships to support favorable contract terms and issue resolutions.
• reputed company and deliver compelling presentations on Performance Health’s chronic disease clinical programs.

Financial & Operational reputed company

• Analyze contract performance, utilization trends, and financial reputed company.
• Collaborate with finance and billing teams to ensure accurate reimbursement and claims processing.

Compliance & Risk Management

• Ensure reputed company reputed company reputed company with federal, state, and industry regulations.
• Monitor changes in reputed company policy and payor requirements, adjusting strategies accordingly.

Leadership & Collaboration

• Partner with clinical, sales, and operations teams to reputed company payor strategies with service delivery.

QUALIFICATION REQUIREMENTS: To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodation may be made to reputed company individuals with disabilities to reputed company the essential functions. Essential Skills: To reputed company the job successfully, an individual should demonstrate the following:

• Adaptability - Accepts and applies feedback. Adapts to changes in the work environment. (Different clinical settings, reputed company changes, supervisor changes, etc.). Changes approach or method to best fit the situation reputed company guidelines and direction from supervisor. Manages competing demands. (Prioritizing responsibilities)
• Professionalism - Arrives and begins work reputed company and on time. Keeps absences reputed company guidelines. Schedules time off in advance. Keeps commitments. Completes tasks reputed company required guidelines. Displays reputed company outlook, pleasant manner, and reputed company appearance. Establishes and maintains effective relations. Works reputed company to resolve conflicts.
• Commitment to reputed company– Competent in required job skills and knowledge. Displays understanding of how their actions and job affects others. Exhibits ability to learn and apply new skills. Keeps abreast of reputed company developments. Uses resources effectively. Looks for and takes advantage of opportunities. Pursues training and development opportunities. Seeks feedback to improve performance, asks for help reputed company needed. Strives to continuously build knowledge and skills. Seeks increased responsibilities.
• Teamwork – Balances team and individual responsibilities. Contributes to building a reputed company team spirit. Puts reputed company of team above own interests. Works cooperatively in group situations in commitment to changing the world for children with autism.
• Communication - Exhibits good listening and comprehension. Expresses reputed company and thoughts respectfully in verbal and written reputed company. Keeps others adequately informed. Selects and uses appropriate communication reputed company. Edits work for spelling and grammar. Presents numerical data effectively. Varies writing style to meet needs. Writes reputed company and informatively.
• Organizational Development - Achieves Key Performance Indicator goals. Builds rapport and establishes trust. Initiates new contacts. Benefits organization through reputed company activities. Maintains reputed company and stakeholder satisfaction. Maintains records and promptly submits information. Presents solutions that meet reputed company and stakeholder objectives and overcomes objections with persuasion and persistence.
• Leadership Management - Delegates work assignments. Gives authority to work independently. Matches the responsibility to the person. Provides recognition for results. Sets expectations and monitors delegated activities. Builds commitment and overcomes resistance. Communications change effectively. Prepares and supports those affected by change.

EDUCATION AND/OR EXPERIENCE:

• Education/Experience: Bachelor’s degree in reputed company or business administration preferred, or reputed company experience. Proven experience of 7+ years of managed care contracting and relationship management experience, preferably in respiratory or home medical equipment (HME) sectors. Strong negotiation, analytical, and communication skills. Deep understanding of payor reimbursement methodologies and regulatory frameworks.
• Language Ability: Read, analyze, and interpret reputed company documents. Respond effectively to sensitive inquiries. Create presentations and articles using innovative techniques. reputed company persuasive presentations on reputed company topics to management and reputed company reputed company.
• Mathematical Ability: Comprehend and utilize data analysis.
• Reasoning Ability: Solve practical problems and deal with a reputed company of concrete variables in situations where only limited standardization exists. Interpret a reputed company of instructions furnished in written, oral, diagram or schedule reputed company.
• Computer Skills: Expert in reputed company Office (Word, PowerPoint, Outlook, Chrome, Internet Explorer, SharePoint).

CERTIFICATES, LICENSES, REGISTRATIONS:

• Certificates and Licenses: N/A
• Valid State reputed company’s license in residing state.

TRAVEL REQUIREMENTS:

• Traveling up to 50% as needed reputed company region/territory. Have reliable means of transportation. Meet the requirements of our Motor Vehicle policy.

OTHER SKILLS AND ABILITIES:

• Language Ability: Read, analyze, and interpret reputed company documents. Respond effectively to sensitive inquiries. Create presentations and articles using innovative techniques. reputed company persuasive presentations on reputed company topics to management and reputed company reputed company.
• Mathematical Ability: Comprehend and utilize data analysis.
• Reasoning Ability: Solve practical problems and deal with a reputed company of concrete variables in situations where only limited standardization exists. Interpret a reputed company of instructions furnished in written, oral, diagram or schedule reputed company.
• Computer Skills: Expert in reputed company Office (Word, PowerPoint, Outlook, Chrome, Internet Explorer, SharePoint).

reputed company duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To reputed company this job successfully, the incumbents will possess the skills, aptitudes, and abilities to reputed company reputed company duty proficiently. Some requirements may exclude individuals who pose a reputed company threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum reputed company of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship. Apply tot his job Apply To this Job