Jobs · Management · Pennsylvania

Director Payer Contracts

ManagementFull-time

About the role

Candidates must be local to Philadelphia, PA.

Responsibilities

  • Oversee payer contracting and support payer strategy functions for the Health System
  • Assess and refine Health System's payer contracts covering all third party plans including Commercial, Medical Assistance, Medicare Advantage, Workers Compensation, International care via Philadelphia International Medicine, and any other payer arrangement
  • Incorporate CMS or Commonwealth based programs beyond traditional FFS programs such as those originating in CMMI
  • Primary contact with health insurers for new product development, service promotion, contracting issues, and pricing
  • Develop and maintain third party payer agreements with health system member institutions and affiliates to optimize revenue
  • Coordinate contracting aspects for TempleCare CIN network management functions and payer contracting

Requirements

  • Master's Degree Required or Combination of relevant education and experience may be considered in lieu of degree
  • 10+ years experience in a related position including 5 years of performance driven contracts and ACO/CIN agreements
  • 7 Years Experience In a Healthcare Provider Environment
  • General Experience in managed care contracting

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