Provider Contracting Director is responsible for the operations of the provider contracts department. Ensures that provider contracts are processed to support accurate and efficient claims payments. Being a Provider Contracting Director oversees the formulation of provider contracts and specific terms. Analyzes contract data and provides financial projections. Additionally, Provider Contracting Director requires a bachelor's degree. Typically reports to top management. The Provider Contracting Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Provider Contracting Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
About the role
The Director of Payer Strategy & Contracting will lead the strategic development and execution & negotiation of telehealth service contracts with payers. This role is responsible for creating and implementing innovative contracting strategies to enhance the Found’s market position and financial performance. The Director will oversee provider enrollment and credentialing functions, manage credentialing vendor(s) and internal team, and work in concert to support the Revenue Cycle Management (RCM) functions. The Director will collaborate with internal stakeholders, including finance, clinical operations, and legal & compliance teams, to ensure the alignment of payer contracts with organizational goals.
What you'll do (Job Responsibilities)
Strategic Planning:
Revenue Cycle Management (RCM) Support:
Provider Enrollment and Credentialing:
Market Analysis:
Contract Negotiation:
Stakeholder Collaboration:
Performance Management:
Education: Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or a related field required. Master’s degree desirable.
Experience: Minimum of 7-10 years of experience in healthcare payer contracting, with a minimum 2-3 year focus on telehealth services.
Skills: