Director Payor Contracting
About UsAkron Children's Hospital is one of the largest independent pediatric hospitals in the U.
S.
, and ranked among the best children's hospitals by U.
S.
News and World Report.
Our dedicated staff serves nearly 900,000 patient visits per year through our 2 hospital campuses and a large network of locations offering primary and specialty care.
We are leading the way to healthier futures for children and communities through expert medical care, research, and prevention and wellness programs.
As a teaching affiliate of Northeast Ohio Medical University and other universities, we train new generations of pediatricians, specialists, nurses and pharmacists every year.
OUR PROMISESTo treat every child as we would our ownTo treat others as they would like to be treatedTo turn no child away for any reasonWe are seeking people who are committed to fostering a diverse environment in which patients, family and staff from a variety of backgrounds, cultures, and personal experiences are welcomed, included and can thrive.
Summary:
Akron Children's Health Collaborative (ACHC) is a newly established 501c4 organization built to improve child health through collaboration with community physicians and contracting with Managed Care Organizations (MCOs).
The role of Director of Payor Contracting will directly report to the Vice President of Payor Strategy, Akron Children's Hospital with matrix relationship to the leader of ACHC.
The role will be responsible for leading key functions and strategic direction for Payor contracting and contract management activities including management of key staff and close collaboration with ACHC leadership.
This role will also be responsible for directing and overseeing the contracting, maintenance and contract management activities, including but not limited to provider enrollment, contract compliance, education and revenue recovery efforts, for the hospital, professional services, ancillary and home health services.
This role will hire, train, coach, counsel, and evaluate performance of any direct reports.
Responsibilities:
Responsible for the overall relationship with our contracted payers.
Develops and maintains successful & collaborative payor relationships (new and existing) through development and execution of agreements that supports the ACHC business model.
Leads and supports payor negotiations with an emphasis on innovative reimbursement structures to advance the best interest of high quality, affordable, patient care.
Negotiates complex, value-based payor agreements and participates in strategic development of payor contracting initiatives.
Implements the contract structures and reimbursement methods and rates for all professional, institutional, ancillary and vendor providers.
Collaborate with ACHC team to support in monitoring and evaluating important aspects of the contract such as financial and quality metrics.
Works closely and collaboratively with operations team members to ensure key processes are effectively functioning to support contract terms and optimize return on investment Negotiates and improves upon stop loss provisions where applicable.
Participates in business development and community efforts and outreach Leads employees, provides direction, coaches, trains and develops, and manages performance to company goals and expectations.
Prepares, manages, and adheres to department budget to maintain expenditure controls.
Other duties as required.
Other information:
Education and Experience Education:
Bachelor's degree in business administration or related healthcare field is required.
Master's degree in Business or Heathcare Administration preferred Certification:
None.
Years of relevant managed care and payor contracting
Experience:
7 to 10 years is preferred.
Years of experience supervising:
3 to 5 years is preferred.
Demonstrated track record of building strong working relationships across health system and other provider organizations and potential payor partners is required.
Ability to think independently and develop new processes/analyses required Strong organizational skills with the ability to multi-task and execute against multiple competing priorities is required.
Proficiency in MS Office or similar software is required.
Experience in fee-for-service modelling payor contracts is required.
Knowledge of pediatric value-based contract methodologies, including capitation and risk-sharing, and financial and administrative terms is preferred Full Time FTE:
1.
000000Akron Children's Hospital is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individual with Disabilities.
EEO is the law, please click/copy paste the link below to learn more:
https:
//www.
eeoc.
gov/sites/default/files/migrated_files/employers/eeoc_self_print_poster.
pdfPosition:
ADMINISTRATIVE.
Estimated Salary: $20 to $28 per hour based on qualifications.
S.
, and ranked among the best children's hospitals by U.
S.
News and World Report.
Our dedicated staff serves nearly 900,000 patient visits per year through our 2 hospital campuses and a large network of locations offering primary and specialty care.
We are leading the way to healthier futures for children and communities through expert medical care, research, and prevention and wellness programs.
As a teaching affiliate of Northeast Ohio Medical University and other universities, we train new generations of pediatricians, specialists, nurses and pharmacists every year.
OUR PROMISESTo treat every child as we would our ownTo treat others as they would like to be treatedTo turn no child away for any reasonWe are seeking people who are committed to fostering a diverse environment in which patients, family and staff from a variety of backgrounds, cultures, and personal experiences are welcomed, included and can thrive.
Summary:
Akron Children's Health Collaborative (ACHC) is a newly established 501c4 organization built to improve child health through collaboration with community physicians and contracting with Managed Care Organizations (MCOs).
The role of Director of Payor Contracting will directly report to the Vice President of Payor Strategy, Akron Children's Hospital with matrix relationship to the leader of ACHC.
The role will be responsible for leading key functions and strategic direction for Payor contracting and contract management activities including management of key staff and close collaboration with ACHC leadership.
This role will also be responsible for directing and overseeing the contracting, maintenance and contract management activities, including but not limited to provider enrollment, contract compliance, education and revenue recovery efforts, for the hospital, professional services, ancillary and home health services.
This role will hire, train, coach, counsel, and evaluate performance of any direct reports.
Responsibilities:
Responsible for the overall relationship with our contracted payers.
Develops and maintains successful & collaborative payor relationships (new and existing) through development and execution of agreements that supports the ACHC business model.
Leads and supports payor negotiations with an emphasis on innovative reimbursement structures to advance the best interest of high quality, affordable, patient care.
Negotiates complex, value-based payor agreements and participates in strategic development of payor contracting initiatives.
Implements the contract structures and reimbursement methods and rates for all professional, institutional, ancillary and vendor providers.
Collaborate with ACHC team to support in monitoring and evaluating important aspects of the contract such as financial and quality metrics.
Works closely and collaboratively with operations team members to ensure key processes are effectively functioning to support contract terms and optimize return on investment Negotiates and improves upon stop loss provisions where applicable.
Participates in business development and community efforts and outreach Leads employees, provides direction, coaches, trains and develops, and manages performance to company goals and expectations.
Prepares, manages, and adheres to department budget to maintain expenditure controls.
Other duties as required.
Other information:
Education and Experience Education:
Bachelor's degree in business administration or related healthcare field is required.
Master's degree in Business or Heathcare Administration preferred Certification:
None.
Years of relevant managed care and payor contracting
Experience:
7 to 10 years is preferred.
Years of experience supervising:
3 to 5 years is preferred.
Demonstrated track record of building strong working relationships across health system and other provider organizations and potential payor partners is required.
Ability to think independently and develop new processes/analyses required Strong organizational skills with the ability to multi-task and execute against multiple competing priorities is required.
Proficiency in MS Office or similar software is required.
Experience in fee-for-service modelling payor contracts is required.
Knowledge of pediatric value-based contract methodologies, including capitation and risk-sharing, and financial and administrative terms is preferred Full Time FTE:
1.
000000Akron Children's Hospital is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individual with Disabilities.
EEO is the law, please click/copy paste the link below to learn more:
https:
//www.
eeoc.
gov/sites/default/files/migrated_files/employers/eeoc_self_print_poster.
pdfPosition:
ADMINISTRATIVE.
Estimated Salary: $20 to $28 per hour based on qualifications.
|
|
 | |
