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Director Managed Care Contracting

Job Details
Masters degree is required
Director, Contracting ? CKHS
The Director of Contracting is responsible for the implementation and coordination of managed care contracting and related activities for Crozer-Keystone Health System (CKHS) under the direction of the Senior Director, Managed Care Contracting. The position is based at CKHS corporate headquarters in Springfield, PA.
The Director shall have primary responsibility for:
Manage assigned portfolio of CKHS payer contracts and relationships for all network hospitals, physicians and ancillary providers. Lead responsibility of negotiating contracts for physicians and ancillary providers, and assigned hospital managed care payers and assists in large scale ($> $15M) contracts under the direction of the Senior Director Managed Care, including rates, payment methodologies, contract language, value based and shared /full risk payment programs, following all internal controls for contract review, approval and signature and in alignment with CKHS vision, goals and objectives.
Assist in the tracking of pay for performance and risk contracts with a focus on improved performance to budget, development and implementation of new reporting and tracking tools and collaboration with payers and sister organizations of CKHS. Supports managed care oversight partial and full risk contracts.
Primary lead for implementation and ongoing management of completed contracts, including identification and tracking of critical contract and renewal dates, proper scanning, recording and filing of contract documents, dissemination and communication of information to internal constituents and education on new /revised terms. Monitor contract performance regarding financial performance, payment integrity, value based payment programs, compliance with contract terms and key performance indicators. Monitoring payer activity with respect to network development, product strategies, payment policies and other relevant market intelligence.
Promote enhanced use of MedAssets and other available contract management tools to support contract negotiations, revenue recovery and contract performance, providing support to decision support, finance and budget on managed care issues.
Prepare and provide training, materials and tools for use by CKHS providers and their staff regarding key managed care contract provisions, market trends and opportunities for improvement in support of facility goals and objectives, consistent with the mission and values of CKHS. Proactively communicate and educate CKHS operational areas regarding contract changes, policy updates, etc., to ensure CKHS staff have information needed to successfully implement and operationalize agreements.
Perform others duties as assigned/required by supervisor.
Candidates must possess the following qualifications:
Master's degree in health care administration or related field required with a minimum of 5 years of managed care contracting for multi-hospital system and or payer and reimbursement analysis in either a provider or payer setting required. Excellent written and verbal communication skills required.
Extensive knowledge, experience and expertise in managed care contracting negotiations, language, modeling analytics, reimbursement methodologies on behalf of hospitals, physicians and ancillary providers, managed care regulations and quality/shared savings program metrics and methodologies.
Excellent skills in Microsoft Office Excel (including advanced spreadsheet and formula manipulation), as well as in Word and PowerPoint. Access skills preferred but not required.
Demonstrated skills in attention to detail, superior project management, implementation and analytical ability as well as the ability to coordinate and lead activities using a collaborative and team approach.
Ability to handle multiple projects and perform independently under tight deadlines with a focus on effective implementation, clear and consistent communication and follow-up.



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