Job description

Who is HNI?

We reveal and realize opportunity - opportunity to transform healthcare to a value-based, patient-centered, sustainable system. A system where clinical, operational and financial outcomes are balanced and optimized. We are relentlessly focused on meeting our partners’ requirements for meaningful results. Our powerful analytics enable informed decisions. Our technology drives clinical workflow. Our honed business processes drive efficiency, and engaged providers act as clinical stewards in the delivery of compassionate care. We engage in partnerships that forge a bold path for a new model of healthcare – and our client’s daring transformation.

What's The Position?

Director of Managed Care Contracting is responsible for leading all managed care contracting functions for the Company. These functions include payor contract identification, negotiation, procurement, performance monitoring, and management of payor relationships.

What Are The Key Responsibilities?

_ Payor Contracting_:

• Manage all components of the contract negotiation process
• Identify the key payors in new markets entered by HNI Healthcare
• Lead the rate and language negotiation discussions with the payors
• Work with HNI’s VP of Revenue Cycle and Managed Care and CFO/COO to ensure negotiated rates are best rates possible for each market
• Provide strategic leadership around negotiating contracts for closed networks
• Ability to multi-task and manage multiple negotiations at the same time
• Work with Operations management to identify and implement contracting opportunities for revenue improvement
• Assist in developing strategy for value-based care contracting

Payor Relations:

• Develop productive and professional relationships with contracted payors
• Works with the HNI RCM department as needed when rates received by payors vary from the contract
• Assist with resolving claim issues resulting from contract interpretation and/or language
• Keep abreast of marketplace changes for payors, networks, reimbursement issues, and changes in legislation or in guidelines at the state and federal levels

Contract Administration:

• Ensure contract files are in order and kept up to date in Conga, our contract management tool
• Ensure contract fee schedules are obtained with the execution of a contract and kept up to date in Conga based on the contract terms
• Provide contract and fee schedules to our billing vendor partner
• Distribute information about new contracts to key Company personnel

Required Job Competencies:

• Strong technical knowledge of payor contracting
• Excellent relationship-building capabilities
• Exceptional written and verbal communication skills
• Excellent negotiation and problem-solving skills
• Strong analytical and interpretive thinking
• Strong computer skills; proficiency with MS Office and common web applications
• Exceptional leadership, interpersonal, and motivational skills
• Track record of success in fast-paced, high-accountability environments
• Ability to identify and resolve issues quickly
• Self-motivated, self-starting personality

Education/Experience:

• 5+ years of progressive managed care contracting experience for healthcare provider organizations
• 1+ years of progressive experience managing contracts in multiple states
• A Master’s degree in business, finance, health care, or a related field is strongly preferred
• Bachelor’s degree in business, finance, health care or related field
• In-depth understanding of hospital-based physician reimbursement
• In-depth understanding of outpatient physician reimbursement
• Demonstrated track record of success within growing organizations engaged in high volumes of M&A activity strongly desired
• Excellent understanding of Federal, State, and local compliance standards

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Supplemental pay types:

• Bonus pay

Application Question(s):

• What is your annual salary requirement?

Work Location: One location

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