Director of Payer Contracting and Credentialing

4 weeks ago


Miami, United States Nicklaushealth Full time
Job Summary

We are seeking a highly skilled and experienced professional to lead our Payer Contracting and Credentialing efforts. As a key member of our team, you will be responsible for developing and implementing strategies to optimize our payer relationships and ensure seamless credentialing processes.

Key Responsibilities
  1. Payer Contracting and Negotiation
  • Develop and maintain strong relationships with payers to negotiate favorable contracts and rates.
  • Collaborate with cross-functional teams to ensure alignment and effective communication.
Credentialing and Accreditation
  • Oversee the credentialing process for healthcare providers, ensuring compliance with regulatory requirements.
  • Develop and implement accreditation strategies to maintain high standards of quality and patient safety.
Financial Analysis and Reporting
  • Analyze financial data to inform payer contracting and credentialing decisions.
  • Develop and maintain reports to track key performance indicators and identify areas for improvement.
Leadership and Team Management
  • Lead and develop a high-performing team of professionals.
  • Provide guidance and support to ensure team members have the necessary skills and resources to succeed.
Requirements
  1. Education
  • Bachelor's degree in Business Administration, Healthcare Management, or related field.
Experience
  • Minimum 4-7 years of experience in payer contracting and credentialing, with a strong background in healthcare finance and management.
Skills and Abilities
  • Strong analytical and problem-solving skills, with the ability to interpret complex data and make informed decisions.
  • Excellent communication and interpersonal skills, with the ability to build strong relationships with payers, healthcare providers, and internal stakeholders.
  • Ability to work in a fast-paced environment, with multiple priorities and deadlines.


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