Provider Contracting Director jobs in Colorado

Why Work at Children's....

Here, it’s different. Come join us.

Children's Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years. Here, the nation’s brightest nurses, physicians, scientists, researchers, therapists, and care providers are creating the future of child health. With an optimist’s outlook, a trailblazing spirit, and a celebrated history, we’re making new strides every day. We’ve been Magnet-designated four times by the American Nurses Credentialing Center and are consistently recognized among the best of the best pediatric hospitals with #1 rankings in Colorado and the region by U.S. News & World Report. As a national leader in pediatric care, we serve children and families from all over the nation. Our System of Care includes four pediatric hospitals, 11 specialty care centers, 1,300 outreach clinics and more than 10,000 healthcare professionals representing the full spectrum of pediatric care specialties. Here, we know it takes all of us, every role, to deliver the best possible care to each child and family we treat. That’s why we build our teams toward a foundation of equity in access, advancement, and opportunity. We know teams of individuals with different identities and backgrounds can nurture creativity and innovation. We know we can see, treat, and heal children better when our team reflects the diversity of our patient population. We strive to attract and retain diverse talent because we know a truly inclusive and equitable workforce will help us one day realize our most basic calling: to heal every child who comes through our doors. A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. Here, it’s different.

SUMMARY

The Director of Provider Integration provides oversight, development and operational support of Children’s Hospital Colorado Pediatric Care Network’s Federal Trade Commission (FTC)-compliant clinically integrated network (CIN) where independent and affiliated faculty physicians and the hospital participate in a formal manner through executed legal documents. Develops and refines strong business relationships with providers including independent practice associations (IPA), large private care or hospital-based physician practices, network administrators and internal business partners leading to the achievement of quality, provider satisfaction, medical cost, financial management, network growth and/or efficiency targets. Facilitate strategic discussions, build consensus, and drive decision-making among cross-functional teams, departments, hospital and physician leaders, and CIN leadership. Collaborates with the Vice President and Medical Director to identify, implement and achieve departmental quality and efficiency goals.

ESSENTIAL FUNCTIONS

An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the functions which the employee may be expected to perform.

• Support functions of Board and Committee work including the development of content with Vice President, Medical Director and committee chairs.
• Ensure smooth operations of PCN programs through management and tracking of performance against board approved goals. Educate staff on PCN goals and set goals and review performance against goals for other PCN management and staff.
• Educate providers and administrators on a variety of financial arrangements including shared risk and gain-share agreements and achievement of performance-based incentive programs and value-based contracts.
• Maintain a proactive approach to identifying opportunities/threats and create solutions to navigate complex scenarios to ensure long term success for the Pediatric Care Network (PCN)
• Provide subject matter expertise on all matters pertaining to clinical integration.
• Promote and advocate for the ideals and value proposition of population health and value-based care to various teams and stakeholders to generate buy-in, support and ownership.
• Ability to manage, maintain and oversee finance for the Pediatric Care Network and execute on business cases for the organization as requested.
• Develop and obtain approval for multi-year quality and safety goals (includes measure maintenance, measure development, and improvement initiatives).
• Manage vendor partnerships and subcontracting and maintain required regulatory reports.
• Support PCN Nurse Care Coordinator to implement patient outreach program as part of broader care coordination efforts, integrating that work into the quality improvement team.
• Leads and oversees PCN data strategy and manages aggregation of clinical data and ongoing maintenance of data feeds across 35 pediatric practices.
• Hire and manage assigned PCN and staff.
• Recruit and manage relationships with physicians, hospitals, staff, and insurance payers to increase program participation and investment in the PCN.
• Build, track, and report on network goals for physicians, administrators, and practices to ensure long term success.
• Oversee provider education activities including development of presentations for orientations and education as part of PCN’s quality program.
• Oversite and leadership of all PCN operations, including quality and process improvement and practice transformation. This includes the strategic development, implementation, and operationalization of our core quality programs supporting our population health and value-based initiatives.
• Ownership of Committee agendas and support of our Committee chairs (all independent community physicians). Manages relationships. This also includes ownership of the Practice Manager Advisory Council, and the relationship management of 35 independent practice managers.
• Working closely with the VP Strategic Provider Integration, the CHCO executive team, managed care team, and legal/compliance teams to advance the Group Practice Subsidiary (GPS) physician alignment strategy. This includes significant input and project management in the strategic development and implementation of this important strategic initiative.

Minimum Qualifications

Education: Bachelor's Degree in healthcare or business administration

Experience: Five (5) years of experience in healthcare environment and two (2) years of management experience

Equal Employment Opportunity

It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information.

The position is expected to stay open until the posted close date. Please submit your application as soon as possible as the posting is subject to close at any time once a sufficient pool of qualified applicants is obtained.

Salary Information

Annual Salary Range (Based on 40 hours worked per week): $114,731.28 to $191,218.79

Benefits Information

Here, you matter. As a Children’s Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children’s Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.