Requisition# 20367

Employment Type

Experience

Location

Region

Application Email

Position Summary:

The Director of Contracting is responsible for developing, organizing, managing and maintaining all CCHP, Chinese Hospital and Hospital Clinic agreements.  The director ensures the appropriate contract terms are present in agreements, including those that serve regulatory and legal requirements. The Director works with senior leadership at CCHP and Chinese Hospital to preserve and grow market share, and to develop and implement network strategies that enhance CCHP member access to quality care.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Develops contract proposals and negotiates provider-payer, provider-provider contracts and contract renewals.
• Develops network strategies with senior management.
• Provides basic drafting and reviews of contractual documents. On standard and nonstandard contracts, provide redlined recommendations.
• Selects appropriate contract vehicle and contract terms in partnership with senior management, clinical, financial, compliance, legal and operational departments.
• Collaborates with above departments to perform financial and utilization analysis in the development and evaluation of rate proposals.
• Facilitates completion, implementation and ongoing monitoring of financial and operational performance standards of contracts.
• Monitors and completes contract execution, extension and/or renewal.
• Assures accuracy and appropriateness of contract text and attachments.
• Establishes and maintains positive relationships and acts as key contact for contract issues with providers and their senior leadership.
• Identifies, creates, revises and implements policies and procedures and workflows to document key department responsibilities and tasks.
• In conjunction with General Counsel, maintains a contract inventory and maintains an organized repository for all executed agreements and related correspondence and documentation.
• Keeps abreast of industry trends, regulations, legislation, and payment rules and methodologies.
• Accepts and performs other duties as assigned.

QUALIFICATIONS

• Bachelor’s degree or BS/BA in business administration or health care related field of study or equivalent years of experience
• Five+ years prior experience in contracting in a health plan
• Strong interpersonal and communication skills and ability to work effectively with a wide range of constituencies
• Ability to develop and deliver presentations
• Excellent time management, organizing and coordinating skills
• Demonstrates solid communication, interpersonal, relationship-building and negotiation skills
• Ability to use financial and utilization data to formulate rate proposals within budgeted financial targets and evaluate financial impact of changes in payment terms
• Strong history of achieving personal and corporate marketing goals and objectives
• Strong skills in Microsoft applications including MS Office
• Demonstrated ability to work independently and take initiative

PHYSICAL REQUIREMENTS

• Able to lift up to 30 pounds
• Use proper body mechanics when handling equipment
• Standing, walking and moving 50% of the
• Occasional local and non-local travel to company and customer

COMPLIANCE REQUIREMENTS

Complies with CCHP and Chinese Hospital’s Compliance Program including Code of Ethics and all statutes, regulations, guidelines applicable to federal and state programs. Responsibilities include, following the guidelines and reporting suspected violations of any statute, regulations, agreements or guidelines applicable to all healthcare programs.