We have a current full-time career opportunity for a seasoned senior healthcare contracting director to handle all health plan 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 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, Fee For Service). 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 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.
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.
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 covers three 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.