Senior Payor Contracting Specialist

Senior Payor Contracting Specialist opening!!!!

We are working on a new position located in Oregon, outside of Portland. Please let me know if anyone qualified comes to mind. Wishing you the best New Year to come!

Title: Senior Payor Contracting Specialist

Hospital overview: 300+bed, not-for-profit regional health system in the beautiful Oregon market. Magnet®-recognized facility, regional referral center and one of the largest acute-care hospitals in Oregon. Approximately 3,500 full and part-time employees.

The Sr. Payer Contracting Specialist is responsible for assisting in strategy development, building internal and external relationships, developing pay for performance contracts with managed care payers, providers, and healthcare networks.

Minimum Qualifications Include:

Bachelor’s Degree in accounting, finance or related field required. Master’s Degree in Business Administration or Healthcare Administration preferred.

Minimum of two (2) years progressive, related experience in one or more of the following: negotiations, relationship management, and/or healthcare.

Core Job Functions Include:
Cultivate relationships with potential organization payer affiliates and partners that have the potential to engage in significant risk-sharing arrangements consistent with organization’s Statement of Common Values and strategic priorities. Negotiate contracts establishing payment rates and terms for services provided by organization’s providers and facilities.

Maintain standard contract language and provisions for all managed care contracts. Collaborate with members of the contracting committee, general counsel, and other internal stakeholders with regard to all contracting strategies and decisions.

Collaborate with the Director of Payer Contracting on development and communication with network contracting and evaluation of system and network risk bearing contracts. Serve as an internal consultant on questions of health plan/payer strategy and risk assumption. Serve as internal consultant and liaison to system and network contracting on questions of health plan/payer accountable care and risk-sharing strategies.

Effectively interact with executive management on strategic interests with payers and provider networks to ensure alignment in contract strategy and health system goals.

Develop innovative payment structures to support internal policies (Pay for Performance, Risk Contracting, and Care Coordination). Evaluate payer partners, and accountable care risk-sharing product-line strategies and business venture opportunities.

Competitive salary range + relocation assistance.

Tina Roberts, President

588 Sutter Street, Suite 349
San Francisco, CA 94102
(415) 770-1200

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