Claims Director Jobs in Rochester, MN (NOW HIRING)

Provides executive leadership of Mayo Clinic's strategies for commercial payer contracts to deliver patient care services and participate in provider networks which total more than $13 billion on an annual basis. Responsible for managing contract activities for all Mayo sites, payers, and programs. Oversees relationships with many types of entities including insurance companies, managed care plans, employers/corporations, business coalitions, high value/COE networks, and even governmental entities.
Also responsible for certain assigned functional activity, contracting programs, and/or service lines across all sites. Functions, programs, and service lines can include product development; transplant contracting; specialty network contracting; government contracting; direct employer contracting; national payer contracting; international contracting; population health contracting; payer financial analytics; contract financial support; healthcare promotions; and various liaison roles.
The Division Chair and its direct reports negotiate financial terms of key contracts directly with payers' senior level management. Responsible for financial performance of contract portfolio for site and assigned functions/programs/service lines.
Responsible for collaborating with physicians, practice administrative, and finance leaders to ensure contracting strategies and activities support the practice/site, strategic initiatives, and financial models. Serves as institutional resource and educates Mayo leadership regarding managed care contracts, payer markets, and competitive trends. Serves as a primary Revenue Strategies and Innovation contact and collaborator for site Administrators, Physician CEOs/Leaders, and CFOs for commercial contracting.
Position Responsibilities:

• Leads, organizes and maintains an effective contracting team which results in Mayo practices being an attractive provider of health services for payers, including strategies to market distinct services available at Mayo practices
• Works collaboratively with Chair, RSI, to provide leadership in commercial contracting area, ensuring Mayo Clinic leaders are informed with regular market surveillance, aware of contracting strategies and new developments, and engaged as new initiatives are considered.
• Develops and maintains strong and positive relationships with all strategically important commercial payers, ensuring they are aware of new clinical programs and services available, Mayo Clinic's core value proposition(s), includes multiple connection points (CEO, CMO, and Rev Cycle in addition to RSI) between Mayo Clinic and each payer organization.
• Oversees the development and execution of commercial payer contracting strategies and initiatives, including specific clinical department objectives that support overall organizational contracting strategies.
• Seeks support and input from Clinical Practice Committee, Executive Operations Team, Board of Governors, and other leadership bodies for strategies.
• Works collaboratively with Clinical Practice Committee's (CPC's), Department/Division Chairs and others to assure appropriate clinical input to commercial contracting activities.
• Works collaboratively with internal administrative (Finance; Revenue Cycle; Marketing; Planning; Legal) and Practice (Executive Health) areas in the development of new initiatives and to address operational objectives.
• Develops an internal organization that is deeply committed to customer service, continuous improvement and manages internal operations to ensure efficient performance.
• Implement policies and procedures to communicate contract terms to appropriate Mayo staff. Ensures sufficient support documentation is in contract files.

This is a hybrid position and must be located within 100 miles of one of the following Mayo Clinic campuses: Jacksonville, FL; Phoenix, AZ; or Rochester, MN, with an expectation to work on-site based on business needs.
Qualifications
Ten (10) years' experience in provider-payer contracting with a track record of success and similar health care finance or administration with demonstrated leadership skills is required. Bachelors' degree, preferably in a business-related field is required. An MBA, MHA or other relevant Master's degree is preferred. A strong foundation and familiarity with healthcare financing, billing/claims, and negotiation strategies is necessary.
Required skills include (a) Strategic thought leadership with ability to lead contracting teams; (b) Excellent communications and interpersonal relations skills, including negotiating skills, to build and sustain positive working relationship with commercial payer executives as well as internal Mayo leadership; (c) Excellent analytical and problem-solving skills to strategically assess contract performance and impact of trends and developments in health care on Mayo Clinic's contracted revenue; and (d) Enthusiasm for collaboration with and across payer boundaries to advance holistic strategies for Mayo Clinic's entire revenue stream.
C.P.A. if position is focused on finance. FSA/ASA (Society of Actuaries) or AAA (Member, Amer. Academy of Actuaries) designations could be considered as an alternative to a C.P.A.
About Us
Why Mayo Clinic
Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
Benefits Highlights

• Medical: Multiple plan options.
• Dental: Delta Dental or reimbursement account for flexible coverage.
• Vision: Affordable plan with national network.
• Pre-Tax Savings: HSA and FSAs for eligible expenses.
• Retirement: Competitive retirement package to secure your future.

About the Team
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.
Equal Opportunity
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.