Director of Payer and Provider Contracting

3 weeks ago

Buffalo, United States Great Lakes Integrated Network, Inc. Full time
Job DescriptionJob Description

The Director of Payer and Provider Contracting is responsible for developing, strategizing, and negotiating contracts with health plans for all lines of business and related product lines, as well as designing partnership opportunities to grow and develop GLIN’s high-performing, clinically-integrated network of providers.

Duties and Responsibilities (including but not limited to)

  • Contract Negotiation
    • Lead the negotiation process for payer contracts, including fee-for-service, value-based, and alternative payment models.
    • Negotiate provider contracts to ensure alignment with payer agreements and IPA objectives.
    • Develop negotiation strategies to optimize reimbursement rates and contract terms.
  • Contract Development and Management:
    • Develop contractual agreements with payers and providers, ensuring compliance with regulatory requirements and ACO policies.
    • Collaborate with legal and compliance teams to review, finalize, and execute contracts.
    • Monitor contract performance and compliance, identifying opportunities for improvement or renegotiation.
  • Relationship Management:
    • Cultivate and maintain strong relationships with payer organizations, including health insurance companies, government payers, and other stakeholders.
    • Collaborate with internal departments, including finance, analytics, operations, legal, compliance, and clinical teams, to align contracting strategies with organizational goals.
    • Serve as the primary point of contact for payer and provider inquiries, escalations, and dispute resolution.
  • Market Analysis and Strategy:
    • Conduct market analysis to identify payer and provider trends, competitive landscape, and opportunities for partnership.
    • Develop strategic initiatives to expand the IPA's network, increase market share, and improve financial performance.
    • Monitor industry changes and regulatory developments to inform contracting strategies and risk mitigation.
  • Performance Evaluation and Reporting:
    • Evaluate contract performance metrics, including reimbursement rates, utilization, and quality outcomes.
    • Prepare and present reports on contract performance to executive leadership and relevant stakeholders.
    • Recommend adjustments to contracting strategies based on performance analysis and market dynamics.
  • Other duties as assigned

Qualifications or Education, Training, and Experience

  • Education: Baccalaureate degree in business, economics, finance, or related field
  • Minimum of 5 years’ experience in healthcare contracting/analytics/network management
  • Minimum of 2 years’ experience managing people, teams, and processes

Knowledge and Skills:

  • An understanding and application of medical billing and reimbursement procedures/practices
  • An understanding of proper negotiation techniques
  • Excellent communication skills, including presentation of complex topics, written and oral communication skills
  • Strategic mindset, with the ability to develop and execute contracting strategies aligned with organizational objectives
  • Ability to work independently in a fast-paced environment
  • Ability to interact with management personnel and the provider community
  • Possess strong organizational skills and attention to detail
  • Ability to multi-task and meet multiple deadlines
  • Adaptive and flexible to new ideas and change
  • Strong supervisory and leadership skills
  • Excellent interpersonal and negotiation skills
  • Strong analytical and problem-solving skills
  • Ability to adapt to the needs of the organization and employees
  • Proven ability to prioritize tasks and to delegate them when appropriate
  • Proficient with Microsoft Office Suite or related software

*This is a hybrid-remote position and candidates must reside in WNY to be considered.

We offer an outstanding benefits package including health, dental, 401K, vacation, and PTO, as well as a great working environment

Pay range: $110,000. to $160,000.

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within job’s compensation range, and will be determined by considering factors including, but not limited to market data, education, experience, qualifications, and expertise of the individual and internal equity considerations

Equal Employment

Our culture encourages individual development, embraces an inclusive environment, rewards innovative excellence, and leads New York in provider and patient satisfaction. Great Lakes Integrated Network (GLIN) values diversity, inclusion, and equity as matters of fairness and effectiveness. We are committed to hiring and retaining a staff that reflects the diversity of the communities we serve, fostering an inclusive working environment where staff of all backgrounds feel welcomed and engaged.

Great Lakes Integrated Network is an Equal Opportunity Employer

  • Director of Payer and Provider Contracting

    2 weeks ago

    Buffalo, United States Great Lakes Integrated Network, Inc. Full time

    The Director of Payer and Provider Contracting is responsible for developing, strategizing, and negotiating contracts with health plans for all lines of business and related product lines, as well as designing partnership opportunities to grow and develop GLIN’s high-performing, clinically-integrated network of providers. Duties and Responsibilities (...

  • Director of Payer and Provider Contracting

    2 weeks ago

    Buffalo, United States Great Lakes Integrated Network, Inc. Full time

    The Director of Payer and Provider Contracting is responsible for developing, strategizing, and negotiating contracts with health plans for all lines of business and related product lines, as well as designing partnership opportunities to grow and develop GLIN’s high-performing, clinically-integrated network of providers. Duties and Responsibilities...

  • Director of Planning

    4 days ago

    Buffalo, United States City of New York Full time

    ***IMPORTANAT NOTE: Only those currently serving as a permanent or probable permanent Administrative City Planner will be considered. *** The NYC Department of Environmental Protection (DEP) enriches the environment and protects public health for all New Yorkers by providing 1.1 billion gallons of high quality drinking water, managing wastewater and...

  • Provider Engagement Account Manager- Key Accounts

    3 days ago

    Buffalo, United States CINQCARE Full time

    CINQCAREPROVIDER ENGAGEMENT ACCOUNT MANAGER - KEY ACCOUNTSPosition DescriptionOverviewThe Provider Engagement Account Manager- Key Accounts is a business development position designed to cultivate and grow relationships with select contracted providers. This position serves as a liaison between CINQCARE and the provider and is responsible for the...

  • Provider Engagement Account Manager- Key Accounts

    4 days ago

    Buffalo, United States Cinq Full time

    Provider Engagement Account Manager– Key Accounts CINQ Connect - Buffalo, NY - Full Time CINQCARE PROVIDER ENGAGEMENT ACCOUNT MANAGER – KEY ACCOUNTS Position Description Overview The Provider Engagement Account Manager– Key Accounts is a business development position designed to cultivate and grow relationships with select contracted providers. This...

  • Provider Engagement Account Manager- Key Accounts

    2 days ago

    Buffalo, United States CINQCARE Full time

    Job Description Job Description CINQCARE PROVIDER ENGAGEMENT ACCOUNT MANAGER – KEY ACCOUNTS Position Description Overview The Provider Engagement Account Manager– Key Accounts is a business development position designed to cultivate and grow relationships with select contracted providers. This position serves as a liaison between CINQCARE and the...

  • Provider Engagement Account Manager- Key Accounts

    3 days ago

    Buffalo, United States CINQCARE Full time

    Job DescriptionJob DescriptionCINQCAREPROVIDER ENGAGEMENT ACCOUNT MANAGER – KEY ACCOUNTSPosition Description OverviewThe Provider Engagement Account Manager– Key Accounts is a business development position designed to cultivate and grow relationships with select contracted providers. This position serves as a liaison between CINQCARE and the provider...

  • Senior Provider Engagement Representative

    4 days ago

    Buffalo, United States Vatica Health Full time

    This Sr. Provider Engagement Representative is responsible for the full range of provider relations and engagement activities for Vatica Health. The Senior Provider Engagement Representative recruits and provides account management for healthcare Practices and their respective providers for Vatica's service offerings. These services include, but are not...

  • Music Director

    2 weeks ago

    Buffalo, New York, United States Buffalo Community Orchestra Full time

    This position description describes the duties and responsibilities of the Conductor and Music Director of the Buffalo Community Orchestra (BCO), a community orchestra, for the season specified in the employment agreement between Buffalo Community Orchestra and the Music Director.A concert season is usually between September 1 and June 15 consisting of four...

  • Assistant Director of Dining Services

    3 days ago

    Buffalo, United States Campus Dining and Shops Full time

    Job titleAssistant Director of Dining ServicesReports toDirector of OperationsDepartmentDining Services AdministrationFLSA StatusFull-Time, ExemptPosition SummaryResponsible for management of all aspects of multiple dining service operations and administrative tasks. Oversee multiple dining operations between three campuses and has multiple direct reports...

  • Assistant Director of Dining Services

    3 days ago

    Buffalo, United States Campus Dining and Shops Full time

    Job titleAssistant Director of Dining ServicesReports toDirector of OperationsDepartmentDining Services AdministrationFLSA StatusFull-Time, Exempt Position Summary Responsible for management of all aspects of multiple dining service operations and administrative tasks. Oversee multiple dining operations between three campuses and has multiple direct reports...

  • Assistant Director of Dining Services

    4 days ago

    Buffalo, United States Campus Dining and Shops Full time

    Job titleAssistant Director of Dining ServicesReports toDirector of OperationsDepartmentDining Services AdministrationFLSA StatusFull-Time, ExemptPosition SummaryResponsible for management of all aspects of multiple dining service operations and administrative tasks. Oversee multiple dining operations between three campuses and has multiple direct reports...

  • Assistant Director of Dining Services

    3 minutes ago

    Buffalo, United States Campus Dining and Shops Full time

    Job titleAssistant Director of Dining ServicesReports toDirector of OperationsDepartmentDining Services AdministrationFLSA StatusFull-Time, Exempt Position Summary Responsible for management of all aspects of multiple dining service operations and administrative tasks. Oversee multiple dining operations between three campuses and has multiple direct reports...

  • Assistant Director of Nursing

    1 week ago

    Buffalo, United States Community Health Center of Buffalo Full time

    The Community Health Center of Buffalo (CHCB) is seeking a Full-time Assistant Director of Nursing (ADON) to join our large, diverse, well-established, growing, and state-of-the-art health center. CHCB offers competitive pay and benefits, including Medical, Dental, Vision, Life Insurance, Supplemental Insurances, 401k match, Tuition Assistance, and Paid Time...

  • Director of Residential Services

    4 weeks ago

    Buffalo, United States The Salvation Army Eastern Territory Full time

    Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Responsible for documentation in compliance with Agency and contract requirements including, but not limited to, ECDSS, FEMA, HUD, Food Director, Residential, Resident, Service, Property Management

  • Sales Director

    4 days ago

    Buffalo, United States Method Recruiting, a 2x Inc. 5000 company Full time

    Sales DirectorREMOTE WHO WE ARE: Our client is the leader in programmatic advertising built for the precision and scale of CTV, addressable, and mobile advertising. Our client works with the world’s largest buyers of advertising, including multi-location brands, agencies, local media groups, networks, and trading desks. With over 130,000 active daily...

  • Sales Director

    5 days ago

    Buffalo, United States Method Recruiting, a 2x Inc. 5000 company Full time

    Sales DirectorREMOTE WHO WE ARE: Our client is the leader in programmatic advertising built for the precision and scale of CTV, addressable, and mobile advertising. Our client works with the world’s largest buyers of advertising, including multi-location brands, agencies, local media groups, networks, and trading desks. With over 130,000 active daily...

  • Regional Director of Sales

    2 weeks ago

    Buffalo, United States Centers Health Care Full time

    Centers Health Care is actively seeking a Regional Director of Sales to lead our Western NY (Buffalo)/Corning based sales teams. The Regional Director of Sales position is a senior level position that reports directly to the Chief Sales Officer of Centers Health Care. The Regional Director of Sales leads a key sales team, including Account Representatives...

  • Regional Director of Sales

    6 days ago

    Buffalo, United States Centers Health Care Full time

    Centers Health Care is actively seeking a Regional Director of Sales to lead our Western NY (Buffalo)/Corning based sales teams. The Regional Director of Sales position is a senior level position that reports directly to the Chief Sales Officer of Centers Health Care. The Regional Director of Sales leads a key sales team, including Account Representatives...

  • Director of Health Services

    1 week ago

    Buffalo, United States Havenwood of Buffalo Full time

    Job DescriptionWhen you work at Havenwood of Buffalo, you have a front-row seat to the amazing life stories of the wisest people on earth. What's more, you are part of an extraordinary company - one that's investing in the future of senior living by investing in you. Don't just do a job. Be part of an extraordinary life! The Havenwood of Buffalo is...