Director of Contracting - Wethersfield, United States - Hartford HealthCare Medical Group

Description

Director of Contracting & Payer Relations

Description

Job Schedule:
Full Time

Standard Hours:

40

Job Shift:
Shift 1

Shift Details:
Work where

every moment

matters.

Every day, over 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here.

We invite you to become part of Connecticut's most comprehensive healthcare network.

Hartford HealthCare (HHC), with a total operating revenue of $5.4B, leverages its unified culture to enhance access, affordability, equity and expertise.

Its care-delivery system, with more than 500 locations serving 185 towns and cities, includes two tertiary-level teaching hospitals, an acute-care community teaching hospital, an acute-care hospital and trauma center, three community hospitals, the state's most extensive behavioral health network, a large multispecialty physician group, a clinical care organization, a regional home care system, Connecticut's largest array of senior care services, and a comprehensive physical therapy and rehabilitation network.

On average, Hartford HealthCare touches more than 17,000 lives every single day.

The unique, system-wide Institute Model offers a unified high standard of care in crucial specialties at hospital and ambulatory sites across Connecticut.

The Institutes include Ayer Neuroscience, Behavioral Health, Cancer, Digestive Health, Heart & Vascular, Orthopedics and Tallwood Urology & Kidney.

Position Summary:

The Director of Contracting and Payer Relations is an integral part of the team that is responsible for negotiating payer agreements that ensure the financial health of HHC while simultaneously navigating the very complex transition from fee for service models of payment to value-based reimbursement methodologies.

The Director will contribute to the development, negotiation, monitoring, and management of all managed care payer contracts within the system, owning the negotiation and management holistically for several payers.

The Director will develop and maintain relationships at various levels with external payers, leveraging these relationships in order to expeditiously resolve issues for the system as well as establish and maintain effective internal relationships throughout the organization in order to obtain input and buy in on contract strategy.

Key Accountabilities:
Manage and improve HHC/ICP's portfolio of managed care contracts for facilities, physicians and ancillaries by negotiating all aspects of the agreements including reimbursement and language ensuring the financial needs of the system are met and that the contracts are administrable thereby reducing any operational burdens
Contribute to the development of the next generation of value-based reimbursement strategy and implement with payers
Oversee contract implementation ensuring all contracts are loaded within specified time parameters with 100% accuracy
Work directly with both internal and external HHC legal counsel on drafting and revising contract language and reviewing any non-compliance issues within current contracts
Develop effective working relationships with various departments within the organization including but not limited to: finance, legal, patient financial services, revenue cycle, hospital and ancillary leadership and clinical departments in order to solicit their input and/or their buy in on contract strategy
Manage large appeals and negotiate settlements and single case agreements
Develop and maintain collaborative relationships with all external payer contacts
Lead the coordination and implementation of the termination process and ensure that it is effectively rolled out throughout the organization
Resolve contract related professional member issues within established time parameters focusing on root cause resolution
Qualifications
Bachelor's degree in hospital administration or related field is required
Fifteen plus years in a managed care environment with significant knowledge of hospital, physician and ancillary contracting. Comprehensive knowledge of value based contracting and management is highly desirable
Comprehensive knowledge of healthcare coding and reimbursement methodologies
Advanced understanding of managed care legal principles and contract language
Superior negotiating skills
Conversant in contract analysis principles
Effective oral and written communication skills with the ability to effectively interact with varied audiences
Self-motivated and results oriented
Strong project management skills
Ability to develop staff and build a high performing team
Ability to build consensus with stakeholders with regards to strategy/direction
Customer service oriented
We take great care of careers.
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth.

Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children.

We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure work/life balance.

Every moment matters. And this is

your moment .

We could tell you more, but why not let our team members handle it? Hear what these Hartford HealthCare employees have to say about working here, in their own words.

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