Emergency Management Director

Emergency Management Director

Tempe, AZ

Director, Network Contracting

Tempe, Arizona Jobs

85281 Jobs

Emergency Management Director Jobs

Emergency Management Directors Jobs

$75,336 - $92,077

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Director, Network Contracting

This position is with a national specialty physician group and is responsible for providing strategic leadership and direction to the contracts department. This position requires a high degree of independence, initiative, judgment, and follow-through on a wide range of sensitive and complex issues.

Director, Network Contracting Responsibilities:

  • Manages all national fee-for-service contracts between MSO practices and payers end-to-end, including contract analysis for compliance/rates, negotiation/re-negotiation, maintenance, contract interpretation and providing guidance to the business, and cataloguing contract information for reference in analysis and internally.
  • Work with the SVP, Payer Contracting to review contract and identify negotiation opportunities.
  • Summarize and synthesize contract to bring proposal to executive level for final approval and signature.
  • Communicate key terms of executed contracts to internal partners, including Revenue Cycle.
  • Serve as a liaison between Revenue Cycle Management and health plan to resolve any questions involving executed contracts.
  • Serve as the initial point of contact for matters defined in a health plan’s contract for administrative disputes that arise with health plans in the normal course of business. Partner with appropriate individuals in the organization to bring closure to those administrative disputes.
  • Develop and maintain a contract management system, including housekeeping and filing of existing contracts and accurate tracking of status of existing contracts, including any amendments and notices.
  • Alert senior and executive leaders as contracts are coming up for renewal or re-negotiation and set in motion a process to keep all contracts current.
  • Maintain an accurate inventory of healthcare individual providers, groups and locations in the database that are common inputs to health plan contracts.
  • Perform market-level research, in partnership with other functions, to understand the payers and health plan products in the market and identify any gaps in contracting.
  • Serve as a subject matter expert on health plan architecture, product offerings, network restrictions, authorization, referral and other components of the health plan marketplace.
  • Manage special projects related to payer market research, payer contracting, rate negotiation, and overall management of all GNS fee-for-service contracts.
  • Work internally to improve and enhance GNS business processes to maintain contract service levels and compliance.

Staff Development:

  • Leads a team of 3-5 including a manager and offshore individuals
  • Facilitates educational opportunities in order to support management team and guides the development of new leaders within the organization.
  • Efficiently and effectively communicates necessary strategic information and acknowledges all communication within 24-48 hours.
  • Owns the creation, implementation, and knowledge transfer of action plans as appropriate.

This role has direct supervisory responsibilities of resources based in Phoenix, AZ and offshore. This role has significant cross-functional input and interaction with revenue cycle, including credentialing and medical services billing. Knowledge of these areas is required.

Director, Network Contracting Preferred Qualifications (Experience, credentials, education)

  • 4+ years of experience in health care services, preferably medical services or managed care and in a leadership position.
  • At least 2 years of experience in network contracting within a medical group or managed care.
  • Bachelor’s Degree in a related field required, Master’s Degree preferred.
  • Excellent written and oral communication skills.
  • Expert proficiency in Microsoft Office, including Outlook, SharePoint, Excel, and PowerPoint.
  • Demonstrated leadership ability.

    Job ID: 4855763219616247900

    This job is located in

    Tempe, Arizona, 85281

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