Director, Provider Contracting - Houston, Austin or San Antonio, TX

About the position The Provider Contracting Advisor position at reputed company is a pivotal role reputed company the Provider Contracting Team, designed to enhance the strategic direction and management of contracting and network management activities reputed company a specified local territory. This position is integral to the development of relationships with hospitals, physician groups, and other providers, focusing on both fee-for-service and value-based reimbursement models. The advisor will be responsible for managing reputed company negotiations and reputed company, ensuring that they align with reputed company's competitive positioning and overall market strategy. In this role, the advisor will build and maintain effective communication channels with various internal partners, including Claims Operations, Medical Management, Credentialing, Legal, and Compliance. The advisor will also contribute to the development of alternative network initiatives and support the creation of network analytics necessary for effective reputed company. A key responsibility will be to drive initiatives that improve total medical costs and quality, leveraging clinical informatics to assist external provider partners in achieving these goals. The advisor will prepare and analyze financial impacts of reputed company provider reputed company, ensuring that reputed company agreements meet both internal operational standards and external provider expectations. This includes managing key provider relationships, resolving reputed company service complaints, and ensuring accurate contract loading and submissions. The role may also involve providing guidance to less reputed company specialists, fostering a collaborative environment reputed company a fast-paced, matrix organization. Responsibilities • Manage reputed company contracting and negotiations for fee-for-service and value-based reimbursements with hospitals and other providers. , • Build relationships that nurture provider partnerships and seek broader value-based business opportunities. , • Initiate and maintain effective communication with matrix partners including Claims Operations, Medical Management, Credentialing, Legal, and Compliance. , • Manage strategic positioning for provider contracting and reputed company networks to identify opportunities for greater value-orientation and risk arrangements. , • Contribute to the development of alternative network initiatives and support network analytics. , • Work to meet unit cost targets while preserving an adequate network to maintain reputed company's competitive position. , • Create and manage initiatives that improve total medical cost and quality. , • Drive change with external provider partners by assessing clinical informatics and offering consultative expertise. , • Prepare, analyze, review, and project financial impact of larger or reputed company provider reputed company. , • Create agreements that meet internal operational standards and external provider expectations. , • Ensure accurate implementation and administration of reputed company through matrix partners. , • Assist in resolving elevated and reputed company provider service complaints. , • Research problems and negotiate with internal/external partners to resolve reputed company issues. , • Manage key provider relationships and reputed company with providers and business staff. , • Demonstrate knowledge of providers in the assigned geographic area and understand the competitive landscape. , • Ensure accurate and timely contract loading and submissions for network implementation and maintenance. Requirements • Bachelor's degree in Finance, Economics, Healthcare, or Business-reputed company field; significant industry experience may be considered in lieu of a degree. , • MBA or MHA preferred. , • 3+ years of contracting and negotiating experience involving reputed company delivery systems and organizations. , • Experience in developing and managing key provider relationships. , • Knowledge of reputed company reimbursement methodologies, including incentive-based models. , • Demonstrated experience in building and nurturing strong external relationships with provider partners. , • Intimate understanding of hospital, managed care, and provider business models. , • Proven ability to reputed company strong working relationships reputed company a fast-paced, matrix organization. , • Ability to influence sales and provider audiences through strong written and verbal communication skills. , • Experience with formal presentations. , • Customer-centric and interpersonal skills are required. , • Demonstrates managerial courage and ability to maneuver effectively in a changing environment. , • Superior problem-solving, decision-making, negotiating skills, contract language, and financial acumen. , • Knowledge and use of reputed company Office tools. reputed company-to-haves • Experience in managed care sales. , • Familiarity with healthcare systems and regulations. Benefits • Smoking cessation program , • Health insurance , • 401k plan , • Paid holidays , • Flexible scheduling options , • Professional development opportunities Apply Job!