Summit Health Inc
Director of Payor Contracting
Summit Health Inc, Colorado Springs, Colorado, United States, 80509
About Our Company
We're a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.
Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.
When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.
Job Description
Reporting to the Vice President of Payor Contracting, the Director of Payor Contracting is responsible for implementing the Organization's contracting strategy in multiple markets. The Director of Payor Contracting will utilize knowledge of fee-for-service contracting and reimbursement methods to assist the organization in achieving its strategic goals.
Essential Job functions:Own, manage, and improve the portfolio of payor FFS, VBR, and other contracts year over year. Establish and manage mutually beneficial partnerships with selected payors within the Colorado market to improve operational and financial performance.Lead market growth through ownership of contract negotiations for Physician, ASC, Ancillary, and other payor contracts within the Colorado marketWork with key market leaders to help develop the organization's overall contracting strategy.Drive advancement of Business Development projects related to Payor partnershipsPartner with the Market President to deliver on strategic objectives and targetsCreate a strategic framework for evaluating new Payor agreementsCultivate, grow, and enhance payor partnerships throughout the marketCoordinate across internal stakeholders(i.e., Clinical Operations, Risk Analytics, Business Development, etc.) to build consensus on key contracting decisions that drive financial and operational performance, workflows, and strategic goals.Own the payor relationship as the primary point of contact.General Job functions:
Exceptional relationship management skills, with both internal and external partiesLeading communication skills (verbal, written, presentation)Ability to manage multiple priorities and short deadlinesKey Competencies:
Detailed knowledge and understanding of contract languageFamiliarity with Value-Based Care conceptsExperience working across key internal stakeholders: Clinical Operations, Legal, Finance, Risk Analytics, etcAbility to succinctly summarize complex agreements into key decision points and impactsExperience building consensus at the Executive level and executive presenceWorking knowledge of Medicare, Medicaid, and Commercial insurance productsEducation, Certification, Computer and Training Requirements:
Bachelor's degree from an accredited collegeA minimum of 5-10 years of professional experience in the healthcare industryA minimum of 3-5 years of professional experience in payor contract negotiationsExperience working with value-based contracts is strongly preferredExperience working within an integrated healthcare system or a health insurance provider is strongly preferred
For Colorado Residents only: This is an exempt position. The base compensation range for this role is $120,000 - $155,000. At VillageMD, compensation is based on several factors including but not limited to education, work experience, certifications, location, etc. The selected candidate will be eligible for a valuable company benefits plan, including health insurance, dental insurance, life insurance, and access to a 401k plan.
About Our CommitmentTotal Rewards at VillageMD
Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD's benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.
Equal Opportunity Employer
Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.
Safety Disclaimer
Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.
We're a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.
Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.
When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.
Job Description
Reporting to the Vice President of Payor Contracting, the Director of Payor Contracting is responsible for implementing the Organization's contracting strategy in multiple markets. The Director of Payor Contracting will utilize knowledge of fee-for-service contracting and reimbursement methods to assist the organization in achieving its strategic goals.
Essential Job functions:Own, manage, and improve the portfolio of payor FFS, VBR, and other contracts year over year. Establish and manage mutually beneficial partnerships with selected payors within the Colorado market to improve operational and financial performance.Lead market growth through ownership of contract negotiations for Physician, ASC, Ancillary, and other payor contracts within the Colorado marketWork with key market leaders to help develop the organization's overall contracting strategy.Drive advancement of Business Development projects related to Payor partnershipsPartner with the Market President to deliver on strategic objectives and targetsCreate a strategic framework for evaluating new Payor agreementsCultivate, grow, and enhance payor partnerships throughout the marketCoordinate across internal stakeholders(i.e., Clinical Operations, Risk Analytics, Business Development, etc.) to build consensus on key contracting decisions that drive financial and operational performance, workflows, and strategic goals.Own the payor relationship as the primary point of contact.General Job functions:
Exceptional relationship management skills, with both internal and external partiesLeading communication skills (verbal, written, presentation)Ability to manage multiple priorities and short deadlinesKey Competencies:
Detailed knowledge and understanding of contract languageFamiliarity with Value-Based Care conceptsExperience working across key internal stakeholders: Clinical Operations, Legal, Finance, Risk Analytics, etcAbility to succinctly summarize complex agreements into key decision points and impactsExperience building consensus at the Executive level and executive presenceWorking knowledge of Medicare, Medicaid, and Commercial insurance productsEducation, Certification, Computer and Training Requirements:
Bachelor's degree from an accredited collegeA minimum of 5-10 years of professional experience in the healthcare industryA minimum of 3-5 years of professional experience in payor contract negotiationsExperience working with value-based contracts is strongly preferredExperience working within an integrated healthcare system or a health insurance provider is strongly preferred
For Colorado Residents only: This is an exempt position. The base compensation range for this role is $120,000 - $155,000. At VillageMD, compensation is based on several factors including but not limited to education, work experience, certifications, location, etc. The selected candidate will be eligible for a valuable company benefits plan, including health insurance, dental insurance, life insurance, and access to a 401k plan.
About Our CommitmentTotal Rewards at VillageMD
Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD's benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.
Equal Opportunity Employer
Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.
Safety Disclaimer
Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.