Director of Provider Contracting

Job Description

Job Description Description:
Job Summary:

The Director of Provider Contracting will be responsible for leading the provider contracting team, developing and managing relationships with healthcare providers, negotiating contracts, and ensuring that our network of providers meets the needs of our members. This role requires a strategic thinker with strong negotiation skills, exceptional leadership abilities, and a deep understanding of the healthcare landscape.

Essential Job Duties:

Develop and implement contracting strategies to build and maintain a robust provider network.
Negotiate and manage contracts with healthcare providers, including physicians, hospitals, and ancillary services.
Ensure contracts are compliant with regulatory requirements and aligned with company policies.
Build and maintain strong relationships with healthcare providers and key stakeholders.
Serve as the primary point of contact for providers regarding contract negotiations, issue resolution, and ongoing relationship management.
Represent the organization at industry events and meetings with providers.
Collaborate with executive leadership to develop and execute the provider network strategy.
Analyze market trends, competitive landscape, and regulatory changes to inform contracting strategies.
Identify opportunities for network expansion and improvement.
Oversee the financial aspects of provider contracting, including budgeting, cost analysis, and financial modeling.
Ensure contracts are structured to achieve cost-effective outcomes.
Requirements:
Skills and Abilities:

Excellent verbal and written communication skills
Proven experience in negotiating complex contracts with healthcare providers
Ability to keep work on multiple projects that may occur at the same time
Excellent customer service skills
Strong analytical and problem-solving skills
Confident decision-making abilities
Detail oriented, flexible, and strong organizational skills
Ability to work independently and within a team environment.
Ability to travel on an as needed basis

Education and Experience:

Bachelor’s Degree in Business or a relevant field
Minimum of 2-5+ years experience
Proficiency in Microsoft Office Suite, especially Excel; Experience with Microsoft PowerBI is a plus.

Physical

Requirements:

Intermittent physical effort may include lifting up to 25 lbs., walking, stopping, kneeling, crouching or crawling may be required
Frequent sitting, use of a keyboard, reaching with hands and arms, talking and hearing approximately 70% of the time; 30% or less time is spent standing
Normal vision abilities required including close vision and ability to adjust focus

Note: The responsibilities and qualifications mentioned above are a general outline and may vary depending on the organization's specific requirements.

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