Director, Payer Contracting - Remote

ABOUT SOUND

Headquartered in Tacoma, WA, Sound Physicians is a physician-founded and led, national, multi-specialty medical group made up of more than 1,000 business colleagues and 4,000 physicians, APPs, CRNAs, and nurses practicing in 400-plus hospitals across 45 states. Founded in 2001, and with specialties in emergency and hospital medicine, critical care, anesthesia, and telemedicine, Sound has a reputation for innovating and leading through an ever-changing healthcare landscape — with patients at the center of the universe. 

Sound Physicians offers a competitive benefits package inclusive of the items below, and more: 

• Medical insurance, Dental insurance, and Vision insurance 
• Health care and dependent care flexible spending account 
• 401(k) retirement savings plan with a company match 
• Self-managed PTO Plan 
• Ten company-paid holidays per year 

ABOUT THE ROLE

Under the strategic direction of the VP, Payer Contracting, The Director, Payer Contracting is responsible is responsible for all duties related to managing national payer relationships, negotiations, financial modeling and tracking of new and existing payer contracts with the primary goals of a) to maximize commercial contract net revenue and b) proactively identify opportunities for the department to increase revenue, save work load, or identify missed opportunities.

In addition to negotiating contracts, this position will involve developing and implementing strategic relationships with major Payers on a national level while working in a matrixed manner with members of the Revenue Cycle, Business Development, Field Operations, Implementation, Financial Modeling, Payer Contracting
Operations, Provider Enrollment and Value Based teams regarding contracting, financial and strategic objectives affecting their specific geographical region and the company.

The Details: This is a virtual, work-from-home opportunity.  

VALUES

• Adaptability: Demonstrates flexibility and a willingness to change as circumstances evolve
• Drive: Motivated to succeed and get things done at a high level of achievement
• Persistence: Demonstrates the ability to “keep at it” even when obstacles or challenges are present; returns to the work at hand after a change of course
• Resourcefulness: Proactive willingness to utilize available information and tools to figure things out
• Strategic Thinking: Demonstrates the ability to look at the big picture and proactively develop a plan of action
• Vision: Demonstrates the ability to see, articulate and share the future of the organization in ways that engage and motivate those around them with a clear vision and plan for the future
• Teamwork: Proactively seek to work with others to accomplish a common goal. Willingness to share challenges and successes with others

ESSENTIAL DUTIES AND RESPONSIBILITES

• Responsible for oversight of the strategic development, coordination and analysis of managed care agreements (Commercial, Medicare, Medicaid, Exchange and Value Based) including rate development and contract negotiations while understanding key decision points and presenting them clearly when a decision needs to be made.
• Responsible for the development and management of their annual national and regional contracting budget
• Understands the nature of the role and organization and will flex, as needed, to mold their role to the organizations needs without being asked
• Generate necessary reports for the VP and executive team; read/report/monitor subordinate reports and performance
• Assess and report progress in meeting department objectives (Budget, Strategic, etc.)
• Understands not only contracting end to end but also understands the whole Revenue Cycle continuum as well as good working knowledge of Health Plan operations
• Mentor Sr. Payer Contracting Managers, Payer Contracting Managers and Payer Contracting Liaisons, as needed, in all aspects of payer contracting activities
• Performs other related duties and special projects as assigned.

KNOWLEDGE, SKILLS AND ABILITIES

• Excellent organizational abilities, written and oral communication skills
• Exceptional commercial contract negotiation skills and experience with physician contracts including excellent knowledge of Medicare reimbursement methodologies, case rate reimbursement methodologies, fee schedule development, utilizing financial models and analysis in negotiating rates with Payers
• Working knowledge and experience of and with value based care reimbursement models and the life cycle of value based care agreements
• Working knowledge of current policies and guidelines that affect contracts, rate development, legislative regulations etc. in the managed care environment
• Creative and persistent problem solver with an ability to present solutions to complex problems
• Attention to detail and accuracy with an ability to summarize difficult concepts to all levels of management in short, consumable bites and/ or concepts
• Client service oriented (both internal and external), harnesses soft skills in communicating difficult decisions and ensuring various levels of colleagues understand messaging
• Ability to interact and communicate with individuals at all levels of organization
• Strong interpersonal skills to handle sensitive situations and confidential information
• Ability to multi-task and prioritize workload in a fast-paced environment
• Anticipates needs three steps ahead and develops mitigation prior to the need
• Ability work in a group setting
• Ability to complete projects independently within established timeframes
• Proficiency with Microsoft Office Suite

EDUCATION AND EXPERIENCE 

• Bachelor’s degree or equivalent experience
• Required - 7 - 10 years in Commercial Managed Care, Payer, Hospital, ASC settings with an emphasis on national contract negotiations (Hospital, ASC and/or Physicians), including 3-5 years of experience managing contractors or contracting teams, contracting budgets and strategic contracting projects (commercial network builds, market corrections, etc.)
• Required: Advanced understanding/knowledge of computer data entry, All Microsoft Office suite products, and ability to navigate through any business related software

Salary Range: $150,000 - $190,000 annually, plus a bonus opportunity. Exact pay will be determined based on candidate experience and geographic location.

Sound Physicians is an Equal Employment Opportunity (EEO) employer and is committed to diversity, equity, and inclusion at the bedside and in our workforce. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, gender identity, sexual orientation, age, marital status, veteran status, disability status, or any other characteristic protected by federal, state, or local laws. 

This job description reflects the present requirements of the position.  As duties and responsibilities change and develop, the job description will be reviewed and subject to amendment.  

Salary : $150,000 - $190,000