Director of Payor Contracting

Role Overview

• Overseeing payor contract directory activities, including submission of new clinicians and adds / changes to health plans.
• Advising the management team on emerging industry trends and methodologies in managed care contracting, payor relations, and legal issues.
• Monitoring new CMS requirements and ensuring contracts meet the requirements.
• Formulating and implementing strategies and initiatives for payor contracting strategies that support business growth and maximizing contract performance and yield.
• Possessing extensive market intelligence in order to negotiate strong contracts, and handle payor escalations when higher level issues need to be resolved.
• Assisting in evaluating new partnerships in collaboration with other functional teams.
• Daily oversight of the contracting teams including establishing metrics to measure performance, monitoring of overall quality, determining team priorities, and managing workflows.
• Identifying or creating tools, financial modeling systems or other resources to assist with payor contract evaluations.
• Ability to analyze complex data sets resulting in payor contract financial modeling.
• Creation of executive leadership and board level presentation materials for purposes of defining Ivy’s payor strategy.
• Engagement in thorough review of market expansion opportunities during due diligence of potential strategic partners and acquisitions.
• Liaison between Ivy operations and Payor partners to remediate payor issues including, but not limited to, claims, credentialing, & authorization.

Requirements

• Bachelor's Degree from an accredited institution preferably in Business Management, Healthcare Administration or equivalent.
• Minimum of 10+ years of experience in a payor contracts focused position in large, clinician-based healthcare networks.
• Must have 4+ years of management experience.
• 10+ years of experience in payer contract negotiations.
• Extensive experience working within a heavy managed care environment.
• Proven ability to solve complex issues and manage complex business relationships.

Benefits

• Eligibility for full benefits package beginning within your first month of employment.
• Generous PTO (Paid Time Off) plans and paid holidays.
• Exceptional Partnerships: Collaborate with leaders like Hospital for Special Surgery (HSS) and educational partners for continuous learning.
• Empowering Values: Live by values that prioritize teamwork, growth, and serving others.