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Director Payer Relations & Contract at Temple Health System
Philadelphia, Pennsylvania, United States -
Full Time

Start Date

Immediate

Expiry Date

14 Jan, 26

Salary

0.0

Posted On

16 Oct, 25

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Payer Contracting, Healthcare Provider Environment, Managed Care Contracting, Performance Driven Contracts, ACO Agreements, CIN Agreements, Revenue Optimization, Network Management, Product Development, Contracting Issues, Pricing, Third Party Payer Agreements, Health System Services, CMS Programs, CMMI Programs, International Care

Industry

Hospitals and Health Care

Description
Reporting to the AVP, Government & Payer Strategy, the Director will oversee the payer contracting and support the payer strategy functions for the Health System. The Director will continuously assess and refine the Health System's payer contracts which will encompass all third party plans including Commercial, Medical Assistance, Medicare Advantage, Workers Compensation, International care via Philadelphia International Medicine, and any other payer arrangement. Additionally the Director will include any CMS or Commonwealth based programs beyond the traditional FFS programs such as those originating in CMMI. The Director is the primary contact with health insurers for the development of new products, promotion of Health System services, contracting issues and pricing. Develops and maintains third party payer agreements with health system member institutions and affiliates to optimize revenue. The Director will coordinate the contracting aspect for the Temple Care Clinically Integrated Network (TempleCare CIN) network management functions and payer contracting. Education Master's Degree Required or Combination of relevant education and experience may be considered in lieu of degree Required Experience 10+ years experience in a related position including 5 years of performance driven contracts and ACO/CIN agreements Required 7 years experience in a healthcare provider environment Required General Experience in managed care contracting Required Licenses
Responsibilities
The Director will oversee payer contracting and support payer strategy functions for the Health System. They will continuously assess and refine payer contracts and serve as the primary contact with health insurers for various functions.