Hospital for Special Surgery, # 1 in Orthopedics and # 3 in Rheumatology is currently looking for a Director Payor Strategy & Contracting who will be responsible for the development and execution of payor agreements that are offered to large employers, payors, and insurance companies that will establish them as the “provider of choice”. These products are aimed at helping reduce costs, improve outcomes, and advance patient satisfaction.
In this unique and exciting new leadership role, the successful candidate, will report to the Senior Director Payor Strategy & Contracting and work collaboratively with a diverse team to oversee the development of a global strategy and framework for various contracts and reimbursement models. The ability to influence and motivate others, as well as work collaboratively within a multi-stakeholder environment will be key.
- Leads development and implementation of successful strategies/solutions to achieve contracting goals.
- Ensures competitive standing through effective collaboration with stakeholders to develop new third party payor agreements.
- Acts as SME for relevant stakeholders on matters of reimbursement models and payor contracting.
- Works to strengthen existing and future business partnerships.
- Provide Payor Strategy team with comprehensive project management leadership and support.
- Manage complex projects end to end.
- Create presentations for Senior Management related to departmental goals
- Bachelors degree required, Masters (MBA) preferred
- Minimum 5 years of leadership experience in managed care, network development coupled with familiarity of new reimbursement models
- Strong entrepreneurial orientation with the ability to critically think and act decisively to effectively impact business goals
- Working knowledge of health-care finance is essential (AP-DRG, APR-DRG, MS-DRG, Ambulatory Surgery Center groupers, APC, APG, and RBRVS reimbursement methodologies).
- Knowledge of hospital operations, health/insurance benefit plans, revenue cycle claims systems and complex reimbursement methodologies preferred.
- A strong customer service orientation as well as the ability to work effectively with people at all levels is essential. Exceptional oral, written and organizational skills coupled with proficiency in Microsoft Office Suite.
- Ability to influence without authority across the organization and engage with Senior Management on business operational issues. Ability to engage with leadership on complex financial concepts