Assistant Director - PHO
Reporting directly to the Executive Director of the PHO, the Assistant Director will work closely and collaboratively with the Insurance payors as well as serve as a liaison to the medical staff and stakeholders.
- Assisting in the Negotiation of physician managed care contracts, analytics and financial modeling.
- Coordinating physician enrollment in managed care plans.
- Insuring compliance of managed care companies with negotiated contracts.
- Following up and resolving payment issues with payors.
- Liaison between physicians and payors.
- Scheduling, coordinating and documentation for all PHO related meetings.
- Developing and managing budget for PHO.
- Compiling information for membership regarding changes and updates in the reimbursement environment.
- Participate in the development of HSS Alternative Payment Methodologies (ie: Episode Based Bundled Payments) to be offered to large employers and insurers.
- Work with PHO Executive Director to develop strategies to sell Alternative Payment Methodologies to employers and insurers.
- Collaborate with Employer and Strategic Partnership Department to create new product offerings to large employers.
EXPERIENCE, COMPETENCIES, AND PERSONAL CHARACTERISTICS:
- Solid experience (minimum 5 years) in any combination of contract negotiations, resolving payment(claims) issues, financial analysis/planning for/in a hospital or Health Insurance company. Major teaching/surgical hospital experience or health plan experience is highly desirable.
- Minimum of 5 years of supervisory, team-related experience is required.
- Hospital Service Line experience highly desirable.
- Technology savvy: excellent understanding of processes and databases; proficient with Excel, Word, and PowerPoint.
- Demonstrated understanding of contract negotiations, finances, operations, regulations, strategic planning, and the hospital/healthcare industry, as well as external environmental forces, is required.
- The ability to influence and motivate others, as well as work collaboratively within a multi-stakeholder environment is required.
- Associate degree required
- Bachelor’s degree preferred