Assistant Director, Payer Contracting and Business Development

divh2Assistant Director Business Development And Payer Contracting/h2pJoin the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world./ppThe Assistant Director Business Development And Payer Contracting partners with leadership to develop and implement payer contracting and business development growth strategies and processes, payer operations processes. In this position, you will manage relationships with third-party payers, community physicians, and employers. Works with partners to develop analytics to support contract negotiation, growth strategies, risk capture, population health and contract analysis and implementation efforts as well as product strategies and payer operations./ppA caregiver in this role works remotely from 8:00 a.m. 5:00 p.m. Candidates for this position are preferred to reside in Ohio, Nevada, or Florida./ppA caregiver who excels in this role will:/pulliAnalyze markets from a strategic perspective, develop managed care strategies and tactics by market, nationally and at the state level./liliProvide work direction and leadership to regional and national caregivers teams within MNS to support the following lines of business including but not limited to: Medicaid, transplants, centers of excellence, regional PPOs, and single case agreements./liliDevelop and implement market and network services goals including but not limited to managed care contracting goals and objectives ensures their execution./liliRecommend and gain support from MNS leadership, institute leaders and operations to ensure optimal implementation of the business development and managed care contracting strategies./liliMaintain awareness of market, payer, and competitive managed care activities and adjust strategies accordingly./liliWork with contract managers, operations, and clinical caregivers to ensure effective implementation of new and renegotiated contracts and to resolve problem payer issues./liliCommunicate effectively with leadership, operations, and contract managers on the status of contracting and problem payer issues./liliReview and negotiate contract language and pricing terms in accordance with budgetary objectives and policy and procedures to maximize benefit to the company./liliRepresent the company to payers and regulatory authorities in matters related to payer account management. Manages not less than 1/3 of the net reimbursement from managed care payers./liliEffectively communicates trends and issues to corporate managed care through ad hoc communications, monthly and quarterly reports./liliWork with corporate managed care to recommend changes in contracting and reimbursement guidelines to ensure achievement of reimbursement maximization as it relates to managed care./liliDevelop playbooks for contracting segments including but not limited to transplant, vision, dental, behavioral health, and value-based contracting to aid in the development of the contract managers and senior contract managers./li/ulpMinimum qualifications for the ideal future caregiver include:/pulliBachelors degree in Finance, Accounting, Business, or Healthcare Administration or related field./liliTen years healthcare management experience in a managed care environment./liliExtensive knowledge of healthcare planning, finance, marketing, reimbursement, operations, and related activities./liliExperience leading process improvement activities across cross functional teams and organization./li/ulpPreferred qualifications for the ideal future caregiver include:/pulliMasters degree/liliExperience managing contracts for regional systems offering comprehensive services/liliExperience working with various insurance plans and diverse healthcare services/li/ulpPhysical Requirements:/pulliRequires prolonged periods of sitting with a light amount of physical work, with maximum lifting of 20 pounds./li/ulpPersonal Protective Equipment:/pulliFollows Standard Precautions using personal protective equipment as required for procedures./li/ulpPay Range/ppMinimum Annual Salary: $112,110.00/ppMaximum Annual Salary: $170,955.00/ppThe pay range displayed on this job posting reflects the anticipated range for new hires. A successful candidates actual compensation will be determined after taking factors into consideration such as the candidates work history, experience, skill set and education. The pay range displayed does not include any applicable pay practices (e.g., shift differentials, overtime, etc.). The pay range does not include the value of Cleveland Clinics benefits package (e.g., healthcare, dental and vision benefits, retirement savings account contributions, etc.)./p/div