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Director Contracting

Company: MMS Group
Location: Chicago
Posted on: October 12, 2018

Job Description:

Director Provider Contracting Chicago National MCO has unlimited opportunity for growth in this expanding market Generous relocation benefits and perks Reporting to the VP Director will coordinate negotiate and handle activities of the provider contracting network development and or provider relations functions and aid in formulating and administering organizational policies and procedures Negotiate large hospital physician groups and ancillary service agreements in accordance with Corporate health plan and government regulations and guidelines Oversee provider contracting activities to ensure efficiency and maintain compliance with Company policies and standards government laws and regulations Develop and implement a network development plan for the assigned region and set of providers and identify and initiate contact with potential providers in support of the Company strategic goals and objectives Effectively integrate new programs and strategies to reach PMPM targets and provide oversight to the provider set up and contract configuration in the computer system to ensure accurate claims adjudication Perform basic financial analyses to identify medical cost improvement opportunities develop strategies to reach financial goals and execute contracting strategies to meet goals and objectives Evaluate and monitor providers rsquo; performance standards and financial performance of contracts Qualifications: Bachelor s degree 5 years of related experience negotiating hospital large physician groups and ancillary service agreements and external customer service for providers Experience in marketing sales medical economics in a managed care or insurance environment Previous management experience including responsibilities for hiring training assigning work and managing performance of staff Experience in provider network management Medicaid Medicare contracting and or claims processing Experience in the Illinois market strongly preferred

Keywords: MMS Group, Chicago , Director Contracting, Executive , Chicago, Illinois

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