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)
GENERAL PURPOSE OF THE JOB:
The Specialist, Payor Partnerships position administers the terms of the contract portfolio with DaVita and health insurance companies. This position researches contract language, documents and tracks portfolio performance of critical contract terms, and communicates with health insurance companies and internal DaVita teams.
SUPERVISORY RESPONSIBILITIES: No
ESSENTIAL DUTIES & RESPONSIBILITIES:
The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all-inclusive.
Research and review contract language as needed
Track portfolio performance
Provide language-strength analyses as needed (e.g. BDP, ad-hoc projects)
Respond to inquiries on facility contracting from internal and external sources
Prepare and send official notices to payors per contractual requirements
Create facility lists to be included as exhibits in contracts or amendments using existing databases & queries
Maintain confidentiality of upcoming deals or negotiations when required
Understand contracting strategies to analyze payor/facility relationships
Participate in meetings with other departmental teams and committees as necessary to facilitate solutions on payor issues
Evaluate and report key performance metrics to department management
Provide recommendations to improve policies, procedures, and performance
Other duties and responsibilities as assigned
Work overtime with little or no notice as needed
Attend team meetings, phone conferences and training as needed
Know, understand, and follow teammate guidelines, employment policies, and department or company procedures
Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position.
MINIMUM QUALIFICATIONS:
Education, licenses, certifications, and experience required to fulfill the essential duties, include computer skills as required.
High school diploma or equivalent required
Associate’s degree in related field strongly preferred
Strong verbal and written communication skills (excellent grammar, spelling, ability to effectively verbalize concepts)
Minimum of two (2) years’ healthcare claims administration, contracting, or payor experience required
Demonstrated knowledge of healthcare contracts preferred
Intermediate computer skills and proficiency in MS Excel, Outlook, Access required; ability to use Internet effectively required; basic familiarity with Oracle Financial System and an electronic billing system strongly preferred.
Go to http://careers.davita.com
What We’ll Provide:
More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.
At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed Diversity & Belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and an affirmative action employer. As such, individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.
Salary/ Wage Range
$17.50 - $30.00 / hourCompensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience and may fall outside of the range shown. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits
0 Provider Contracting Director jobs found in Kent, WA area