Executive Director - PHO
Reporting directly to the Vice President of Payor Strategies and Contracts, the Executive Director will work closely and collaboratively with senior leadership throughout the Finance Department as well as serve as a liaison to the medical staff and stakeholders.
- Negotiating physician managed care contracts
- 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
- Liaison between Cornell, New York Hospital and HSS
- Scheduling, coordinating and running all PHO related meetings
- Developing and managing budget for PHO
- Providing information to membership regarding changes and updates in the reimbursement environment.
- Participating in the development of HSS Alternative Payment Methodologies (ie: Episode Based Bundled Payments) to be offered to large employers and insurers.
- Working with Senior Management to develop strategies to sell Alternative Payment Methodologies to employers and insurers.
- Collaborating with Employer and Strategic Partnership Department to create new product offerings to large employers.
EXPERIENCE, COMPETENCIES, AND PERSONAL CHARACTERISTICS:
- Solid experience (minimum 7 years) in contract negotiations, financial analysis/planning for/in a hospital, and familiarity of new reimbursement bundled payment models is required. 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.
- Bachelor’s degree required
- Master’s degree in a related field is preferred.