Assistant Director, Payer Contracting and Business Development

                    

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

                        

We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.

                                    

Job Title

Assistant Director, Payer Contracting and Business Development

                        

Location

Cleveland

                    

Facility

Remote Location

                     

Department

Market and Network Services MNS-Finance

                      

Job Code

T98125

                     

Shift

Days

                       

Schedule

8:00am-5:00pm

                       

Job Summary

                         

Job Details

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world.    

 

The Assistant Director Business Development and Payer Contracting partners with leadership to develop and implement payer contracting and business development growth strategies and processes, payer operations processes. In this position, you will manage relationships with third-party payers, community physicians, and employers. Works with partners to develop analytics to support contract negotiation, growth strategies, risk capture, population health and contract analysis and implementation efforts as well as product strategies and payer operations. 

 

A caregiver in this role works remotely from 8:00 a.m. – 5:00 p.m.  

Candidates for this position are preferred to reside in Ohio, Nevada, or Florida. 

 

A caregiver who excels in this role will: 

• Analyze markets from a strategic perspective, develop managed care strategies and tactics by market, nationally and at the state level. 

• Provide work direction and leadership to regional and national caregivers teams within MNS to support the following lines of business including but not limited to: Medicaid, transplants, centers of excellence, regional PPOs, and single case agreements. 

• Develop and implement market and network services goals including but not limited to managed care contracting goals and objectives ensures their execution. 

• Recommend and gain support from MNS leadership, institute leaders and operations to ensure optimal implementation of the business development and managed care contracting strategies. 

• Maintain awareness of market, payer, and competitive managed care activities and adjust strategies accordingly. 

• Work with contract managers, operations, and clinical caregivers to ensure effective implementation of new and renegotiated contracts and to resolve problem payer issues. 

• Communicate effectively with leadership, operations, and contract managers on the status of contracting and problem payer issues. 

• Review and negotiate contract language and pricing terms in accordance with budgetary objectives and