Executive Director of Contracting and Payer Relations 277938

Executive Director of Contracting and Payer Relations - Days

• Dover, DE
• Full Time Days
• $140,000-$225,000/Year (Experience Based)
• ASAP Start Date

Forbes 2024 List of Best Place to work by State! Ranked #3 in Delaware!

Our healthcare system has more than 4,500 employees.

We are 90 minutes from Philadelphia, Washington, DC and Baltimore. Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!

Our facility offers competitive salary and a comprehensive benefits package including:

• Paid Time Off and Paid Holidays
• Matching 401(k)/403(b) Plans
• Excellent Health, Dental, Vision, Disability and Life Insurance options

Status:Full Time 80 Hours

Shift: Days

SALARY STARTING: $140,940.80 YEARLY

General Summary:

Reporting to the CFO, the Executive Director of Contracting & Payer Relations is responsible for all aspects of managed care, governmental, value-based and population health/clinical integration for our facility. The position is charged with developing and improving relationships with third-party payers. As a key member of the Revenue Cycle team, the senior director ensures reimbursement rates are as robust as possible and that third-party payers are abiding by the contract terms. The Executive Director works collaboratively with the other Revenue Cycle leaders and key stakeholders to make certain that everyone is aware of, and strives to correct, issues or disagreements arising with payers.

Responsibilities:

1. Negotiates agreements with third-party payers to achieve operating terms and reimbursement rates that will support our strategic goals.
2. Generates reports that describe the successes and opportunities in the revenue cycle.
3. Meets with leadership of Delaware based plans to discuss strategic plans and opportunities for improvement and collaboration.
4. Recommends managed care contracting strategy to CFO.
5. Serves as the primary source of communication and liaison with third-party payers.
6. Fosters effective collaboration between departments to ensure a consistent and integrated approach in daily operations to managed care requirements.
7. Collaborates with Denials Department to create effective appeals.
8. Conducts regularly scheduled meetings with third-party payers to improve payment processes and follow-up on claims due and other outstanding issues.
9. Represents our facility in state-wide meetings and participates with regional associations.
10. Accountable for the overall success of our managed care strategy.
11. Maintains the EPIC contract management system.
12. Ensures that annual payment adjustments are accurate and complete.
13. Creates Price Transparency machine-readable files each year.
14. Serves on utilization review, level of care, and readmission committees.
15. Negotiates single-case agreements as required.
16. Provides input on charge master development and adjustments.
17. All other duties as assigned, within the scope and range of job responsibilities.

Required Education, Credential(s) and Experience:

• Education: Master Degree Business Administration
• Credential(s): None Required
• Experience: Required: Minimum 10 years of contract negotiation with Managed Care Organizations

Preferred Education, Credential(s) and Experience:

• Education: Master Degree Health Administration or Related field
• Credential(s): Certification related to the position, if applicable.
• Experience:

Job Type: Full-time

Pay: $140,000.00 - $225,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• Day shift

Education:

• Master's (Required)

Experience:

• Contract negotiation with Managed Care Organizations: 10 years (Required)

Work Location: In person

Salary : $140,000 - $225,000