Director of Payor and Provider Partnerships

1 week ago

Chicago, IL, United States AltaStaff Full time
Job Position: Director of Payor and Provider Partnerships

Location: Chicago, IL 60608

Pay Rate: $100,000.00 - 130,000.00, based on experience.

Description: Reporting to the Chief Progress Health, the Director Payor & Provider Services will be a people manager and role model to the PHO and Disease Management staff. This role will be responsible for providing strategic management and daily direction in the achievement of the Quadruple Aim for the ACO.

JOB RESPONSIBILITIES:

• Leads and builds the Care Management Model and continues to add to the refinement of the care models for the HTC Collaboratives, e.g. Wellness West and Southside Healthy Community Organization and MHN ACO

• Operation management which oversees the daily functions, e.g. credentialing, pharmacy management, quality management, patient out-reach, etc.

• Develop, implement and execute on key KPI measures for all programs, e.g. HEDIS to ensure our population health

• Manages PHO operation to ensure an on target budget sinaichicago.org

• Partners with IT staff to develop the PHO's Salesforce platform for our population health work. Work with MHN ACO's vendor, MHNU, on the further development of MHN Connect, the technology platform used for administration of the ACO work

• Seeks ways for process improvement for reporting the shared savings package for providers and codevelops the reporting needs for our clinically integrated network of providers

• Manages the PHO's TPA on a daily basis for all operational work

• Manages a growing team of clinicians and non-clinicians in the execution of all MCO and population health duties

• Performs other duties as assigned

Education and Work Experience:

• 10+ years of experience in managed care PHO/IPA management in both a capitated and fee for service environment required

• Associates or Bachelors degree is preferred but not required. Experience in this domain is preferred over college experience

Knowledge and Skills:

• Experience Preferred in EPIC and MEDITECH software systems

• Experience with Microsoft Suite, especially Excel, Pivot tables, required

• Experience with Sales Force, a plus

INDHP

AltaStaff is an Equal Employment Opportunity Employer. We provide equal employment opportunities to all qualified applicants for employment without regard to age, race, color, creed, religion, sex, marital status, national origin, ancestry, citizenship, disability, veteran status, sexual orientation, or any other protected status, in accordance with applicable federal, state, and local laws.

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