Legacy Community Health Services, Inc.
Director of Payor Contracts
Legacy Community Health Services, Inc., Houston, Texas, United States, 77246
Be a part of driving healthy change in our communities
About the Position
The Director of Payor Contracts at Legacy Community Health will be responsible for negotiating payor contracts and leading the contracting team in payor relations, credentialing, and privileging. You will also be responsible for developing a long-term payor contract strategy and lead Legacy's transition to value-based care agreements. Key Responsibilities
Develop and maintain effective working relationships with insurance company and managed care company personnel responsible for contracting with healthcare providers Negotiate managed care contracts including language, rates, amendments, etc. and monitor financial performance maximizing opportunities for net revenue improvement, volume/growth, and effectiveness of collection efforts Develop contract structures that are in concert with the manner in which care is delivered, allow for costing of care in order to develop and negotiate adequate rates, are easy to administer, and make sense in relation to the size and exclusiveness of the contract Analyze the significance and value of potential contracts; determine the cost of the care based on care delivery and contract structure; and project contract performance based on modeling of actual and representative samples Monitor contract performance and other provisions to ensure compliance, identify problem areas, and resolve disputes About Legacy Community Health
Legacy Community Health is a premium, Federally Qualified Health Center (FQHC) that provides comprehensive care to community members regardless of their ability to pay. Our goal is to treat the entire patient while improving their overall wellness and quality of life, in addition to providing free pregnancy tests, HIV/AIDS screening. At Legacy, we empower patients to lead better lives by promoting healthy behaviors and offering resources such as literacy classes, family planning services, and nutrition and weight management information. Our roots began in 1981 as the Montrose Clinic, with specialization in HIV education, testing, and treatment. Since then, the agency has expanded to 10 clinics in Houston, one in Baytown, two in Beaumont, and one in Deer Park with extensive services that include: Adult primary care, HIV/AIDS care, pediatrics, OB/GYN and maternity, dental, vision and behavioral health. We also service students within KIPP and YES Prep schools. Legacy is committed to driving healthy change in our communities. Requirements
Bachelor's Degree in Accounting, Business Administration, or Finance 5 years of progressively responsible managed care contracting experience in a payor or healthcare setting 3 years of experience in a medium to large health system Benefits
Medical, Dental, and Vision insurance Long-Term Disability insurance Life insurance and AD&D 403(b) retirement plan Employee Assistance Plan Subsidized gym membership 24-hour travel assistance Paid Time Off PTO Exchange Program Company holidays (9 days + 1 floating day) Bereavement Leave And more Legacy Community Health is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace. #J-18808-Ljbffr
About the Position
The Director of Payor Contracts at Legacy Community Health will be responsible for negotiating payor contracts and leading the contracting team in payor relations, credentialing, and privileging. You will also be responsible for developing a long-term payor contract strategy and lead Legacy's transition to value-based care agreements. Key Responsibilities
Develop and maintain effective working relationships with insurance company and managed care company personnel responsible for contracting with healthcare providers Negotiate managed care contracts including language, rates, amendments, etc. and monitor financial performance maximizing opportunities for net revenue improvement, volume/growth, and effectiveness of collection efforts Develop contract structures that are in concert with the manner in which care is delivered, allow for costing of care in order to develop and negotiate adequate rates, are easy to administer, and make sense in relation to the size and exclusiveness of the contract Analyze the significance and value of potential contracts; determine the cost of the care based on care delivery and contract structure; and project contract performance based on modeling of actual and representative samples Monitor contract performance and other provisions to ensure compliance, identify problem areas, and resolve disputes About Legacy Community Health
Legacy Community Health is a premium, Federally Qualified Health Center (FQHC) that provides comprehensive care to community members regardless of their ability to pay. Our goal is to treat the entire patient while improving their overall wellness and quality of life, in addition to providing free pregnancy tests, HIV/AIDS screening. At Legacy, we empower patients to lead better lives by promoting healthy behaviors and offering resources such as literacy classes, family planning services, and nutrition and weight management information. Our roots began in 1981 as the Montrose Clinic, with specialization in HIV education, testing, and treatment. Since then, the agency has expanded to 10 clinics in Houston, one in Baytown, two in Beaumont, and one in Deer Park with extensive services that include: Adult primary care, HIV/AIDS care, pediatrics, OB/GYN and maternity, dental, vision and behavioral health. We also service students within KIPP and YES Prep schools. Legacy is committed to driving healthy change in our communities. Requirements
Bachelor's Degree in Accounting, Business Administration, or Finance 5 years of progressively responsible managed care contracting experience in a payor or healthcare setting 3 years of experience in a medium to large health system Benefits
Medical, Dental, and Vision insurance Long-Term Disability insurance Life insurance and AD&D 403(b) retirement plan Employee Assistance Plan Subsidized gym membership 24-hour travel assistance Paid Time Off PTO Exchange Program Company holidays (9 days + 1 floating day) Bereavement Leave And more Legacy Community Health is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace. #J-18808-Ljbffr