Director, Payer Contracting - Remote

Job Details Description

About

Sound Founded in 2001 and headquartered in Nashville, TN, Sound Physicians is a nationally respected, physician-led medical group practicing in 400 hospitals across 45 states. Our team of 4,000 clinicians and 1,000 business professionals across the country is united by one mission: to build exceptional clinical partnerships that unlock quality, affordable, dignified care for everyone – no matter who they are or where they live. With physician-led clinical teams and more than two decades of operational expertise, we’ve refined what it takes to consistently deliver exceptional care in hospital medicine, emergency medicine, critical care, anesthesia, and telemedicine.

Why join us

? A remote-first culture that values flexibility and collaboration Opportunities to grow your career while making a real impact A team that champions inclusivity, innovation, and excellence Whether working virtually or onsite at one of our practices, you’ll be part of a purpose-driven organization shaping the future of healthcare. Sound Physicians offers a competitive

benefits

package inclusive of the items below, and more: Medical insurance, Dental insurance, and Vision insurance Health care and dependent care flexible spending account 401(k) retirement savings plan with a company match Paid time off (PTO) begins accruing immediately upon start date at a rate of 15 days per year, in accordance with Sounds PTO policy Ten company-paid holidays per year

About the Role

Under the strategic direction of the VP, Payer Contracting, The Director, Payer Contracting is responsible for all

duties

related to managing national payer relationships, negotiations, financial modeling, and tracking of new and existing payer contracts with the primary goals of a) maximizing commercial contract net revenue and b) proactively identifying opportunities for the department to increase revenue, save work load, or identify missed opportunities. In addition to negotiating contracts, this position will involve developing and implementing strategic relationships with major Payers on a national level while working in a matrixed manner with members of the Revenue Cycle, Business Development, Field Operations, Implementation, Financial Modeling, Payer Contracting Operations, Provider Enrollment and Value Based teams regarding contracting, financial and strategic objectives affecting their specific geographical region and the company. The Details This is a virtual, work-from-home opportunity.

Travel 1-2 trips a year.

Must have

experience

with contracting in Western states such as CA, WA, OR Essential

Duties

and

Responsibilities

Responsible for oversight of the strategic development, coordination and analysis of managed care agreements (Commercial, Medicare, Medicaid, Exchange and Value Based) including rate development and contract negotiations while understanding key decision points and presenting them clearly when a decision needs to be made. Responsible for the development and management of their annual national and regional contracting budget Understands the nature of

the role

and organization and will flex, as needed, to mold their role to the organizations needs without being asked Generate necessary reports for the VP and executive team; read/report/monitor subordinate reports and performance Assess and report progress in meeting department objectives (Budget, Strategic, etc.) Understands not only contracting end to end but also understands the whole Revenue Cycle continuum as well as good working knowledge of Health Plan operations Mentor Sr. Payer Contracting Managers, Payer Contracting Managers and Payer Contracting Liaisons, as needed, in all aspects of payer contracting activities Performs other related

duties

and special projects as assigned. Values Adaptability: Demonstrates flexibility and a willingness to change as circumstances evolve Drive: Motivated to succeed and get things done at a high level of achievement Persistence: Demonstrates the ability to “keep at it” even when obstacles or challenges are present; returns to the work at hand after a change of course Resourcefulness: Proactive willingness to utilize available information and tools to figure things out Strategic Thinking: Demonstrates the ability to look at the big picture and proactively develop a plan of action Vision: Demonstrates the ability to see, articulate and share the future of the organization in ways that engage and motivate those around them with a clear vision and plan for the future Teamwork: Proactively seek to work with others to accomplish a common goal. Willingness to share challenges and successes with others Knowledge,

Skills

, and Abilities Excellent organizational abilities, written and oral communication

skills

Exceptional commercial contract negotiation

skills

and

experience

with physician contracts including excellent knowledge of Medicare reimbursement methodologies, case rate reimbursement methodologies, fee schedule development, utilizing financial models and analysis in negotiating rates with Payers Working knowledge and

experience

of and with value based care reimbursement models and the life cycle of value based care agreements Working knowledge of current policies and guidelines that affect contracts, rate development, legislative regulations etc. in the managed care environment Creative and persistent problem solver with an ability to present solutions to complex problems Attention to detail and accuracy with an ability to summarize difficult concepts to all levels of management in short, consumable bites and/ or concepts Client service oriented (both internal and external), harnesses soft

skills

in communicating difficult decisions and ensuring various levels of colleagues understand messaging Ability to interact and communicate with individuals at all levels of organization Strong interpersonal

skills

to handle sensitive situations and confidential information Ability to multi-task and prioritize workload in a fast-paced environment Anticipates needs three steps ahead and develops mitigation prior to the need Ability to work in a group setting Ability to complete projects independently within established timeframes Required: Advanced understanding/knowledge of computer data entry, All Microsoft Office suite products, and ability to navigate through any business related software

Education

and

Experience

Bachelor’s degree or equivalent

experience

Required - 7 - 10 years in Commercial Managed Care, Payer, Hospital, ASC settings with an emphasis on national contract negotiations ( Hospital, ASC and/or Physicians, Independent Physician Associations), contracting budgets and strategic contracting projects (commercial network builds, market corrections, etc.) Contracting

experience

with west coast states, CA, WA, OR etc. Salary Range 50,000 - 80,000 annually, plus a bonus opportunity. Exact pay will be determined based on candidate

experience

and geographic location. Sound Physicians is an Equal Employment Opportunity (EEO) employer and is committed to diversity, equity, and inclusion at the bedside and in our workforce. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, gender identity, sexual orientation, age, marital status, veteran status, disability status, or any other characteristic protected by federal, state, or local laws.

This

job description

reflects the present

requirements

of the position. As

duties

and

responsibilities

change and develop, the

job description

will be reviewed and subject to amendment. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.