Director of Payer Relations

Role Overview

Summary/Objective: The Director of Payer Relations is responsible for evaluating, negotiating, and securing financially and administratively favorable managed care contracts with new and existing health plans/managed care organizations. This position will be responsible for day-to-day oversight of the managed care contracting department and its related processes.

Essential Functions: 

• Coach, mentor and develop the Managed Care Contracting Team. Provide effective performance management through annual performance review, employee recognition, and disciplinary actions as necessary.
• Select new hires and oversee onboarding. Assess daily staffing and assign workload in an equitable and efficient manner to meet department deliverables.
• Assist in creating and executing a managed care strategy consistent with the organization’s long-term vision.
• Actively manage a contract portfolio, including negotiating new and existing contracts.
• Create and administer processes and protocols to ensure smooth and timely implementation of contract terms.
• Review industry market rates and data to ensure rates remain in a market competitive position.
• Maintain positive payer relations. Regularly meet with payers to develop relationships and assist in resolving payer issues.
• Analyze and estimate the financial impact of managed care contracts.
• Identify and create relevant data analytics databases, dashboards and reporting.
• Stay abreast of existing and future government payer regulations, managed care contract terms and regulations, industry regulations and all other conditions that may affect payment rates/trends.
• Create an environment of continuous process improvement.
• This position works remotely; work site attendance may be required from time to time in accordance with business conditions.
• Promote NorthStar Anesthesia’s Core Values.
• Demonstrates regular, reliable and predictable attendance.
• Performs other duties as required.

Qualifications:

• Bachelor’s degree preferred and 8 years’ experience in payer contracting or other relevant healthcare administrative function (e.g., revenue cycle management, health plan administration, network development)
• Prior management experience (2 year)
• Master’s degree in relevant field (e.g., healthcare or business administration) preferred
• Proven record of achievement in negotiating competitive contract rates utilizing innovative contracting methodologies
• Experience with payer contracting and contract modeling in a provider, hospital, and/or health system environment
• Strong knowledge of managed care and provider regulatory environment and compliance issues
• Financial analysis and negotiation skills
• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies. 

Knowledge, Skills and Abilities:

• Customer Service/Client Focus 
• Strategic Thinking 
• Technical/Professional Knowledge and Skills  
• Communications (Verbal, Written and Formal – presentation)  
• Individual Leadership/Influencing  
• Teamwork/Collaboration  
• Complex Analysis/Problem Assessment  
• Judgement  
• Attention to Detail  
• Business Acumen  
• Integrity

Qualifications

The Company

Company Philosophy

NorthStar provides quality anesthesia care while improving efficiency and accountability. It’s a proven performance-driven approach that’s better for everyone – patients, hospital administrators, surgeons, and anesthesia providers.

Company Mission

To provide the best clinical care and to help hospitals and surgery centers succeed.

NorthStar Anesthesia Overview

NorthStar Anesthesia was founded in 2004 by an anesthesiologist and CRNA (certified registered nurse anesthetist) that saw firsthand the frustrations and daily challenges caused by the traditional anesthesia care model.  

What if they could fix the broken anesthesia care model? What if anesthesia contractors stopped being absentee managers? What if patients, surgeons, providers and hospital administrators were treated more like customers and less like cogs in the system? The answer was NorthStar.  NorthStar Anesthesia is an anesthesia management company that provides anesthesia services to large and small hospitals, surgery centers, hospital administrators, surgeons, anesthesia providers and patients.

Today, NorthStar has over 180 facility contracts across 21 states and employs more than 2,500 providers nationwide.

NorthStar is backed by world-class financial partners.  It is a portfolio company of TPG, a global private investment firm with more than $70 billion in assets under management.  NorthStar has also recently announced a partnership with Cranemere, a holding company that partners with outstanding businesses for the long term. 

Benefits Include Medical, Dental, Life, Long Term/Short Term, Malpractice, 401k and more.

EEO/AA/M/F/Veteran/Disability Employer