Payer Contracting Director
Payer Contracting Director
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Salary Not Disclosed
1 Vacancy
Job Description
The Payer Contracting Director works directly with market leaders through development evaluation negotiation and maintenance of Privias value based contracts with payers and potentially with other providers. This role provides leadership in contracts administration and as a representative of Privia Medical Group (PMG) with payers in the groups market areas.
Primary Job Duties:
- Manage cross functional workstreams across a variety of teams including Payer Contracting Population Health Management Performance Management and Analytics
- Manage strategic relationships with payers
- Manage difficult strategic issues with Payer Contracting and Population Health Leadership
- Makes strategic recommendations based on assessment of market opportunities
- Responsible for assessing legal and financial implications of all contracting opportunities including new contacts contractual amendments and assignments to existing contracts
- Represents Privia Medical Group to third party payors
- Works with Legal Finance Revenue Cycle Management and other teams to develop workable business arrangements that are consistent with Privias contracting goals
- Assists in development of policies and procedures for contracting which meet the market demands and which are consistent with the needs of Privia Medical Group stakeholders
- Collaborate with internal stakeholders to develop financial analytics financial impact scenarios and profitability metrics as a key element in the contract proposal process
- Monitor contract performance and help develop tactics for remediation of underperforming contracts
- Responsible for managing contract development process on behalf of Privia Medical Group providers including contract proposals preparation of contracts for contract language value based and shared/full risk payment programs following all internal controls for contract review approval and signature in alignment with Privias vision goals and objectives
- Ability to personally gain access to key payer decision makers for targets in geography of responsibility
- Analyze and estimate financial impact of managed care contracts as requested by senior leadership
- Some travel is required
- Perform other duties as assigned
Qualifications :
- Bachelors degree preferred. Healthcare Masters or MBA highly preferred.
- 6 years of experience working in health plans health systems or provider organizations;
- Thorough understanding of managed care insurance products and their financial impacts on payers and providers; understanding of contracting processes and operations required
- Must be able to effectively function in highlevel negotiation activities and possess strong negotiating skills
- Able to grasp both clinical and business concepts
- Strong analytical skills; Quantitative and financially focused
- Project manager able to juggle multiple projects and urgent deliverables
- Strategic and flexible thinker who assesses situations carefully and delivers scalable recommendations and results
- Must comply with all HIPAA rules and regulations
The salary range for this role is $125000 to $150000 in base pay and exclusive of any bonuses or benefits (medical dental vision life and pet insurance 401K paid time off and other wellness programs). This role is also eligible for an annual bonus targeted at 15% & restricted stock units. The base pay offered will be determined based on relevant factors such as experience education and geographic location.
Additional Information :
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only not applicable for onsite/in office work):
In order to successfully work remotely supporting our patients and providers we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age color national origin physical or mental (dis)ability race religion gender sex gender identity and/or expression marital status veteran status or any other characteristic protected by federal state or local law.
Remote Work :
Yes
Employment Type :
Fulltime
Employment Type
Remote
Company Industry
Key Skills
- Fundraising
- Management Experience
- Coaching
- Analysis Skills
- Strategic Planning
- Team Management
- Budgeting
- Leadership Experience
- Mentoring
- Public Speaking
- negotiation
- Supervising Experience
