AMSURG Corp is seeking a Director, Contracting (HPR Relations) to lead the effort of securing and maintaining optimal reimbursement rates with our health plan partners. In this role, you will be responsible for achieving annual pipeline goals while establishing and maintaining positive business relationships with facilities, health plans, and internal AmSurg teams.
What You'll Do
- Negotiate initial or renewal contractual terms and reimbursement with designated market payers.
- Manage multiple concurrent negotiation activities using strong project management skills to drive progress on strategies that optimize reimbursement.
- Create and maintain relationships between AmSurg providers and payers related to contracting.
- Facilitate updating and maintenance of a consolidated contract management system for accurate tracking of terms and conditions.
- Establish regular communication and strong inter-company relationships, monitoring payer issues related to provider participation, contract loading, and payment issues alongside the Revenue Cycle team.
- Assist in developing departmental goals, execute projects to achieve them, and work closely with others in the HPR Department to monitor performance.
- Onboard acquisitions and new entities or locations to payer contracts as requested.
- Develop reports and presentations by collecting, analyzing, and summarizing information and trends.
- Collaborate with the Vice President to analyze contract performance data and conduct onsite visits that require market-specific strategies.
- Facilitate internal training or create educational tools related to health plan contracting.
- Travel overnight up to 25% of the time.
What We're Looking For
- Six to ten years of relevant experience in healthcare, including managed care contracting, payment methodologies, contract language, contract negotiations, and financial analysis.
- Strong negotiating skills with national and regional payors.
- Solid understanding of payer contract language and multiple payment methodologies.
- Demonstrated proficiency with financial reports, utilization trends, and patient mix analysis.
- Experience working in a matrix environment with multiple and competing customer demands.
- Ability to build relationships with providers, external vendors/payers, and employees at all levels.
- Strong organizational, written, and verbal communication skills.
- Excellent ability to manage to deadlines, work independently with little supervision, and handle multiple simultaneous tasks effectively.
- Ability to positively handle conflict, maintain a professional manner, and exercise good judgment.
- Self-directed with a strong bias for action and urgency.
- Direct experience working with health plans.
- Fluency in Microsoft Office applications.
- Bachelor’s degree with an emphasis in finance, accounting, or healthcare administration.
- Must be detail oriented, organized, and maintain high integrity and confidentiality.
- Flexibility to work some evenings and weekends as approved to meet contract renewal deadlines.
Nice to Have
- Project management experience.
- Medical group operations experience.
- Health plan operations experience.
- Financial reporting experience.
- Value-based contracting experience.
Technical Stack
- Microsoft Office
Team & Environment
You will work in a matrix environment, collaborating closely with the Vice President and the Revenue Cycle team.
Benefits & Compensation
- Paid Time Off (minimum of 20 days up to 25 days per calendar year).
- 9 observed holidays.
- Paid family leave.
- Medical, Dental, Vision, Life, and Disability insurance.
- Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking, and HSAs.
- Matching 401(K) Plan.
Work Mode
This is a remote position. Candidates should be based in the California area of the United States.
AMSURG is an Equal Opportunity Employer (EOE). Qualified applicants are considered without regard to age (40 or older), race, color, religion, gender, sex, national origin, pregnancy, sexual orientation, disability, genetic information, or any other protected status.
