• Assistant Director - PHO

    Location US-NY-New York
    Posted Date 2 months ago(10/2/2019 9:49 AM)
    Job ID
    2019-11419
    Category
    Finance
    Emp Status
    Regular Full-Time
    Hours per Week
    35
    Shift
    Days
  • Overview

    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.

     

    RESPONSIBILITIES::

    • 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.

    EDUCATION:

    • Associate degree required
    • Bachelor’s degree preferred

     

     

     

     

     

    Other Requirements

    #LI-AG1

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