Director of Contracting and Provider Relations |
| Location: | Salt Lake City, UT |
| Salary Range: | Commensurate with experience |
| Exempt/Non-Exempt: | Exempt |
| Benefits: | Strong benefit package including retirement and health plan options |
| Employment Type: | Full Time |
| Employer: | University of Utah |
| Description: | Position responsible for the following activities:
� Professional services contracting, including strategy development for an academic multi-specialty group practice within the competitive landscape of the Utah market.
� Supports physician leadership in preparation and planning for Contracting Committee and associated subcommittees.
� Evaluates contract opportunities based on operational, administrative, legal and financial analyses.
� Coordinates contracting-related activities, including contract evaluation, rate impact modeling, contract language review, negotiations, delegation of credentialing, contract implementation and contract compliance.
� Communicates throughout the organization on issues related to contracts, payer policies and procedures, payer benefit programs, etc.
� Communicates routinely with departments to provide education, respond to specific department concerns or questions, and develop strategy to optimize reimbursement.
� Serves as liaison on behalf of providers with payers to initiate change, resolve issues, and improve processes.
� Coordinates provider enrollment activities to assure payers are notified in a timely manner of provider changes and assure Payers� member and marketing materials, including provider directories and websites are current.
� Accountability for the day-to-day operations associated with enrolling providers with government and commercial payers.
� Other duties as needed.
University of Utah JOB# PRN01398B, U of U Medical Group |
| Duties: | Essential Functions:
1. Contract Evaluation. Evaluate contacting opportunities through detailed financial analysis, market knowledge, legal and administrative analysis of contract language, etc.
2. Contract Negotiation. Negotiate terms of contracts with payers.
3. Contract Communication Process. Communicate terms of contracts/contract opportunities to contracts dissemination group, including administrative managers, billing managers and physicians. This process includes soliciting feedback from various constituencies and incorporating this feedback into contract negotiations and directly responding to this feedback.
4. Contract Compliance. Responsible for auditing payment against contract terms, recovery of payment variances, escalation of issues to legal counsel as indicated. Resolve inaccuracies related to fee schedule issues, payment policy modifications, or other payment practices that impact professional revenue. Assure payers are notified of annual fee schedule increases as per terms of contract.
5. Contract Implementation. Develop and oversee processes for implementation of contracts, including dissemination of appropriate information to both providers and payers. Take lead in resolving contract implementation issues.
6. Contract Performance Monitoring and Reporting: Assure standardized contracting performance reports are available to departments. Review data to identify contract performance issues. Assist with department requests for additional analysis.
7. Professional Services Charge master: Responsible for establishing market competitive pricing for pediatric sub-specialty services. Assist departments with pricing as requested.
8. Provider Enrollment Management. Oversee activities and manage provider enrollment function
9. Payer Relations. Develop relationships with key individuals at payers to build/maintain relationships.
10. Other duties related to contracting, contract performance analysis, payment compliance, and provider relations � as needed.
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| Qualifications: | Bachelor�s degree in a clinical field, Health Care Administration, Business Administration, or related area, or equivalency; eight years of progressively more responsible management experience; and demonstrated leadership, human relations and effective communications skills required. Completion of hospital provided supervisory training within one year of employment is also required. Master�s degree in Health Care Administration, Business Administration, or related area preferred.
PREFERENCES
1. Must demonstrate excellence and achievement in negotiations w/ experience in health care contracting.
2. A minimum of 3-5 years experience and detailed knowledge of all aspects of health care delivery systems.
3. Strong skills in strategic decision-making, financial analyses, communications, contract negotiations, analysis and modeling.
4. Excellent written and verbal communications skills and presentation skills.
5. Competence in spreadsheet and database applications.
6. Management experience required
TO APPLY, VISIT: http://utah.peopleadmin.com/postings/13346
EQUAL EMPLOYMENT OPPORTUNITY
The University of Utah is an Affirmative Action/Equal Opportunity employer. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities. The University of Utah is committed to diversity in its workforce. Women and minorities are encouraged to apply. |
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