In this role you will be responsible for providing key financial and business intelligence support and direction for provider contract negotiations building cross functional processes and structure including creation of key performance measurements, fee schedule determinations and reimbursement model development. In partnership with Provider Services, you will oversee strategic finance activities to develop and implement the strategic provider reimbursement contracting model.
Key role responsibilities:
• Lead a focused finance team to forecast, compile and track the performance impact of innovative provider reimbursement contracting strategies
• Manage the development and execution of contracting models and analytics
• Partner with Provider Services and Operations to ensure that operational and administrative capabilities are clearly established to manage contract and services strategies
• Qualify and quantify contract terms and conditions with the ability to articulate comprehensive recommendations to physicians, hospitals and other health care providers
• Continually review and assess contract language to mitigate risk and surpass compliance expectations
• Support the development and implementation of key contract strategies, negotiation planning and execution
• Create, evaluate and monitor provider financial performance standards & financial performance of contracts
• Collaborate with key stakeholders both internally and externally to maintain contract compliance
• Works collaboratively with the Senior Leadership team, prepares and presents analytic reports and business recommendations to senior management and other internal stakeholders
Key qualifications and experience:
• 8+ years financial management experience with proven leadership capabilities in designing, developing and implementing process structure, tools and measurement indicators that drive operational results
• 5+ years successful track record supporting contract negotiations supporting relationships with hospitals, provider groups, and integrated delivery systems
• Experience managing reimbursement methods, profiling techniques and pay for performance programs
• Demonstrated success in securing input from contracting providers as a means to improve plan decision making policy development process
• Successful track record developing creative, workable strategies and tactics to accomplish division, corporate and plan goals
• Reputable record of execution of complex projects and programs while managing operational and health care cost budgets
• Superior verbal presentation and written communication skills
• Proven ability to develop strong interpersonal relationships, as a leader and team member
Bachelor's Degree in Finance or related field with at least five years of leadership experience in health care business financial analysis, planning and reporting, or equivalent combination of education and job related experience. MBA preferred
Willingness to Travel - Occasionally
The above statements are intended to describe the general nature and revel of work being performed. They are not intended to be an exhaustive list of all duties, responsibilities, and skills.
Our Recruiter will initiate a phone call to you and give you immediate consideration should your resume meet the job requirements. Please rest assured that if your resume matches what is reflected in this job posting, you should receive a phone call from a CER Recruiter to discuss this position with you.
CER is an equal opportunity and affirmative action employer. All qualified applicants will be considered without regard to age, race, color, national origin, ancestry, sex, sexual orientation or preference, religion, marital status, citizenship, veteran status, or physical or mental disability.
About Competitive Edge Recruiting:
Competitive Edge Recruiting is a Certified Woman Business Enterprise (WBE#6688). We are committed to providing an unparalleled level of service to our clients. Our sole purpose is to ensure that you receive the right person for your organization. At Competitive Edge Recruiting, we use the efficiency of our network and direct recruiting model, coupled with our vast list of current candidates, to find the best person that fits your need. We use a limitless network of professionals, in addition to over 40+ years of combined staffing and recruiting experience to ensure that you are satisfied with the service and quality Competitive Edge Recruiting delivers.
Our experience and track record for success ensures our ability to identify and recruit qualified and productive employees. Our dedicated staff provides our clients with quality individuals within many different disciplines. The "Competitive Edge Recruiting Way" represents recruiting through an international network of candidates.
Competitive Edge Recruiting specializes in Accounting & Finance, Information Technology, Engineering and Human Resources and Sales & Marketing recruiting. In addition, we also offer complete General Office & Administrative staffing.
Posted 3 years ago
Finance and Insurance,