What are the responsibilities and job description for the Director of Payor Contracting position at Altais, Inc.?
About Our Company
At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. At Altais, we're building breakthrough clinical support tools, technology, and services to let doctors do what they do best : care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include : Brown & Toland Physicians, Family Care Specialists and Altais Medical Groups.
About Your Team
Are you looking to work with a high performing, fast growing and dynamic Inpatient Contracting team? We are 4,000 physicians, working in over 40 cities throughout California, caring for more than 500,000 patients. If you are passionate about reshaping healthcare and want to work for a mission driven organization where new ideas and innovation are valued, then we would like to meet you.
About Your Work
This position is responsible for developing, contributing toward and supporting Altais's business strategy of revenue maximization, membership growth and retention, network expansion and improved health plan and provider relations as it relates to health plan contracting for a variety of healthcare business types, i.e. medical group, IPA, clinically integrated networks, for all product types; i.e. HMO, PPO, ACO, and for all risk types; i.e. ACO, shared risk, dual risk, global risk.
Primary duties include developing and executing strategy, analyzing contract performance, optimizing payer relations, market analysis and healthcare trends, collaborating with all internal operations teams to maximize performance and revenue earnings, all in pursuit of achieving the overall company strategy goals and initiatives. Additionally, this role will be responsible for leading a team with direct reports.
You will focus on :
- Identify, develop, and implement corporate contracting strategies, business opportunities, and methodologies for contract negotiations, stabilizing health care costs and / or decrease expenses to remain within company budget and align with company objectives.
- Cultivate and maintain strong relationships with payer organizations and health plans.
- Negotiate reimbursement rates, terms and conditions while ensuring compliance with regulatory requirements and industry standards.
- Monitor and analyze payer contract performance, identify opportunities for improvement, and implement strategies to optimize contract outcomes.
- Analysis collaboration with Enterprise Analytics team and other business entities to ensure all upstream and downstream operational impacts are considered and addressed.
- Collaborate cross-functionally with internal teams such as finance, legal, network management, clinical, etc. to ensure seamless implementation and adherence to contract terms.
- Effectively communicate contract details and changes to relevant stakeholders, creating internal and external resources.
- Leads in resolving elevated and complex contractual issues.
- Stay updated on industry trends, market dynamics and regulatory changes affecting payer contracting strategies to make informed decisions and to adapt contracting approaches.
- Participate in external provider meetings and internal operational meetings to continuously improve relationships, processes, operations and best practices.
- Present payer contracting updates routinely to executive stakeholders.
- Responsible for management and training of contracting team on operational changes, department updates and upcoming projects.
The Skills, Experience & Education You Bring
Required Education : Bachelor's degree from accredited 4-year university or equivalent coursework or equivalent experience in managed healthcare related field; Master's degree preferred.
Minimum Experience : This role requires 10 years professional managed healthcare administration experience, with 5 years people management experience in healthcare / contracting related positions
You Share Our Mission & Values :
Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate's starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.
The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate's qualifications, skills, and experience.
Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our 'CPRA Privacy Notice for California Employees and Applicants' to learn how we collect and process your personal information when you apply for a role with us.
Physical Requirements : Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office / deskwork - Activity level : Sedentary, frequency most of workday.
External hires must pass a background check / drug screen. Qualified applicants with arrest records and / or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
