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Director of Healthcare Contracting Strategy

1 week ago

Orlando, Florida, United States Orlando Health Full time
About the Role

As a seasoned executive, you will lead our physician managed care contract negotiations, ensuring favorable financial and administrative terms for Orlando Health. Your expertise in healthcare contracting will guide contract analysts, driving day-to-day operations to yield the most beneficial outcomes.

Responsibilities
  • Negotiate contracts, amendments, and letters of agreement with payors.
  • Build relationships with physician leadership teams to effectively represent physicians during negotiations.
  • Direct efforts of Physician Contracting Analysts, emphasizing timely review and approval of payor rate sheets, contract matrices updates, and regular performance monitoring.
  • Collaborate with Senior Directors of Hospital, Ancillary, and Specialty Contracting to address all Orlando Health services during negotiations.
  • Ensure accurate listing of accepted insurances on the Orlando Health website, maintaining compliance with state and federal transparency regulations.
  • Support revenue cycle leaders in addressing physician-related payor issues, including referrals, authorizations, panel openings/closings, and accounts receivable.
  • Lead Joint Operating Committee (JOC) meetings for physicians, integrating with other directors as necessary.
  • Manage projects adding physicians via acquisition or new hiring to existing managed care contracts within acceptable timeframes.
  • Collaborate with Credentialing Verification Organization (CVO) to ensure proper credentialing and recredentialing of physicians and practice locations, and accuracy of payor directory listings.
  • Align with Population Health/Value-Based Care team to leverage Orlando Health's performance with payors.
  • Participate in system-wide education and training programs for revenue cycle staff, facilitating in-person learning and online resources.
  • Maintain compliance with all Orlando Health policies and procedures.