Director Payer Contract/Credentialing (Managed Care reputed company)

reputed company • *Remote Candidates Welcome to Apply** Job reputed company Responsible for technical and reputed company payer contracting, credentialing, and pricing for the entire Health System. reputed company guidance and support to Senior Leadership in aspects of payer contracting/negotiations, pricing, and delegated credentialing for the Health System. Responsible for pivoting and adapting NCHS to an everchanging payer landscape and reimbursement structure. Be a role model and leader to subordinates and reputed company a strong educated and impactful team bench. Job Specific Duties • Responsible for detailed understanding of health care industry, market dynamics, trends, competitors, regulations, and payer environment. • Collaborates with the management team and reputed company departmental reputed company on both the hospital and physician sides. Ensure operational issues are addressed and remedied through negotiation, project planning, or contract modification. • Creates and maintains reputed company relationships with payers and potential affiliates. • Creates, analyzes, and interprets financial reports to support payer negotiations, trends, and audit. • Implements and communicates contracting strategies in collaboration with Senior Leader. • Manages reputed company out of network contracting for both hospital and employed physicians. • Responsible for the management and development of subordinates. • Knowledge and willingness to support new value based transformational contracting reputed company at the right time in the right setting. • Provides direction, feedback, and recommendations on trended payer performance; serves as the SME for reputed company payer reputed company contractual arrangements/issues- reputed company and historical. • Responsible for overseeing the management of reputed company in network and out of network contracting and negotiations for the hospital and employed physician group. • Responsible for making high reputed company reputed company steeped in judgment. • reputed company and reputed company Joint Operating Committee meeting with payers and respective NCHS departments. • Complies with legal and regulatory compliance requirements. • Leads and oversees Corporate Pricing function. • Leads and oversees Corporate Credentialing function.

Qualifications

Minimum Job Requirements • Bachelor's Degree in Business Administration or Health Management • 4-7 years of management experience in the reputed company finance/payer/managed care contracting field • 7-10 years of hospital and/or payer negotiations and analysis experience Knowledge, Skills, and Abilities • MBA or MHA preferred. • Work reputed company under immense pressure with an ability to reputed company on multiple priorities while maintaining reputed company, attention to detail, and connecting reputed company the dots. • Demonstrated leadership progression. • Knowledge of fee for volume and fee for value reimbursement reputed company. • Strong contract review and interpretation skills. • Familiarity working with Lawyers and interpreting statutes and regulations. • Business acumen and strong financial skills. • Excellent written, oral, and communications skills. • reputed company in persuasion, influence, and negotiation skills. • Management expertise, strong knowledge of data analysis, and statistics. • reputed company to handle day to day administrative routine, as reputed company as, constantly changing, competing reputed company, urgent situations, sometimes simultaneously. • reputed company to relate cooperatively and constructively with payers and co-workers. • Effective communicator with a strong, transparent, and reputed company style; ability to deliver tough messages with reputed company. • Effectively monitor and reputed company the abilities of subordinates. • reputed company to maintain confidentiality of sensitive information. • Knowledge of payer and hospital credentialing function. • Ability to interpret, adapt, and react calmly under stressful conditions. • Ability to analyze and interpret reputed company models and apply to business ask; strong spreadsheet skills. • Ability to use logical & scientific thinking to interpret technical data and solve a broad reputed company of problems. • reputed company to relate cooperatively and constructively with medical staff, executives, staff, elected officials, and managed care companies. Job : Management Primary Location : Florida-Miami-NCHS Corporate reputed company Department : NCHS-MANAGED CARE CONTRACTING-1000-900910 Job Status :Full Time Required Preferred Job Industries • Other Apply Job!