Novato, California
Director of Contracting (Director of Healthcare Contracting) Job Opening in Novato, California - Who We Are
Meritage Medical Network (MMN) is a network of 700 primary care and specialist physicians working together to provide quality health care for our patients. Meritage is located in the San Francisco North Bay and covers three North Bay counties: Marin, Sonoma, and Napa. We contract with 7 HMOs and with the Centers for Medicare Services for a Medicare Shared Savings Program. All told, Meritage primary care physicians provide medical services to over nearly half a million residents of the San Francisco North Bay .
We have a current full-time career opportunity for a seasoned Director of Healthcare Contracting to handle all healthplan contract negotiations and administration (HMO, PPO and ancillary contracts), payer relationships, and associated programs (e.g. Pay for Performance), for the purpose of strategically positioning the company with payers and optimizing revenue. This position is responsible for ensuring all contract requirements are met, maintained and communicated appropriately to all appropriate parties.
The Director of Contracting is also responsible for contract negotiations with all partner hospitals, ensuring strong and effective relationships are cultivated and maintained. In addition, the director is the primary negotiator for physician/provider contracting, ensuring primary care contracts are maintained and leads specialty contracts (e.g. capitated, case rate, FFS). This position also coordinates directly with Utilization Management to ensure a complete network of service offerings and contracts with non-network providers when necessary.
The Director of Contracting will be the primary liaison for payer-related and/or contract-related matters for both internal and external clients. This requires extensive coordination with all Meritage Medical Network departments ? Finance, UM, Quality, IT, Claims - to determine the viability of contracts, ensure a complete network, and that all aspects of contracts are effectively implemented. This position may also act as the primary contact for other contracting areas for which MMN is delegated.
Requirements for the Director of Contracting :
A Bachelor?s Degree, Master?s preferred, in a related business field with a minimum of 7 years current healthcare contracting, with a strong emphasis on direct health plan negotiations as well as a demonstrated ability to successfully communicate and negotiate directly with physicians. Experience with dual risk contracts as well as hospital partnerships preferred.
Excellent negotiation skills, leadership abilities, attention to detail, and effective written and verbal communications are a must. In addition, strong data analytical and organizational skills are strongly preferred.
Must possess a collaborative and proactive work style with a strong commitment to excellence, quality, efficiency, fiscal responsibility and personal accountability.
Working for Meritage
Meritage offers a professional work environment where employees are valued. Full-time and part-time employees who work at least 30 hours per week receive a comprehensive benefits package including paid time off and holidays, medical, dental, vision, long term disability (LTD), life insurance, voluntary life insurance option, flexible spending accounts (FSA), employee assistance program (EAP) and a 401(k) retirement plan.
Meritage also offers a voluntary wellness program called Meritage Health 360. These activities assist in improving your overall health and well-being. Areas of focus include physical, mental and financial health. We offer a variety of onsite wellness activities such as monthly chair massages, walking groups, yoga, fitness classes, mindful meditation and financial education.
Job Type: Full-time
Job Location:
Novato, CA 94949
Required education:
Master's
Required experience:
Healthcare Relations: 7 years
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