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Director, Provider Contracting
Health Care Service Corporation. Develop and manage contracting strategies for commercial and government networks .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in developing and managing contracting strategies for commercial and government networks, with a strong focus on negotiation, relationship management, and compliance with healthcare policies. Proven ability to oversee budgets, analyze reimbursement strategies, and lead teams to achieve operational goals.
Highest-signal resume keywords
Hospital/Healthcare ContractingNegotiation SkillsLeadership SkillsReimbursement StrategiesBudget Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Contract NegotiationReimbursement Agreement DraftingFinancial ReportingCost-Benefit AnalysisOperational ReportingNetwork Adequacy AssessmentProvider RelationsMarketability StrategiesCompliance with HIPAAResource Allocation
Soft Skills
Clear CommunicationInterpersonal SkillsTeam-Building SkillsPresentation SkillsProblem-Solving Skills
Industry Keywords
Healthcare Delivery SystemsProvider CategoriesContractual DisputesDiversity PrinciplesCorporate Integrity
About the role
Key responsibilities & impact- Develop and manage contracting strategies for commercial and government networks
- Develop, negotiate, and complete reimbursement contracts
- Ensure network adequacy for commercial and government networks
- Draft reimbursement agreements and negotiate contracts for hospitals, large professional groups with special pricing, and hospital-based physicians
- Achieve competitive advantage in discounts and access through contract negotiations and relationship management
- Develop strategies and negotiate contracts for newly recognized provider categories
- Oversee analysis and reporting for reimbursement strategies and take corrective action as needed
- Resolve issues and contractual disputes
- Oversee staff, ensuring goals are met, positions are filled, training is provided, and communications are shared
- Manage budget, operational reporting, and financial reporting
- Communicate with co-workers, management, customers, and leadership
- Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other applicable policies
- Maintain confidentiality of company business
- Perform special projects as required or requested
- Travel as needed, including overnight stays
Requirements
What you’ll need- Bachelor’s degree plus 5 years’ experience in hospital/health care contracting or hospital/physician relations
- 5 years management experience
- Experience working with large integrated health care delivery systems and complex reimbursement strategies
- Experience proactively developing and maintaining relationships with health care provider leadership teams
- Knowledge of outpatient and provider reimbursement strategies and policies
- Experience with financial matters such as contract performance and impact
- Experience developing creative, win-win solutions involving provider contracts, networks, marketability, and profitability
- Negotiation skills
- Leadership skills
- Clear and concise verbal and written communication skills, including interpersonal, presentation, and team-building skills
- Experience meeting deadlines and working well under pressure
- Experience working across departments to accomplish initiatives and goals, build consensus, drive initiatives, gain support, and develop workable solutions
- Ability and willingness to travel, including overnight stays
- Experience overseeing budgets and allocating resources
- Ability to translate needs and initiatives into compelling business cases
- Ability to conduct cost-benefit analyses to justify investments and ensure ROI
- Remote employees must live within the continental United States, excluding Alaska, California, Hawaii, or New York
- Sponsorship is not available
Benefits
Comp & perks- Curated development plans and professional development
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
- Annual incentive bonus plan
- Other incentives