Director, Network Contracting and Support
HumanaAbout the role
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The Director, Network Contracting and Support (Director, Contract Tools, Education, Processes) supports successful national and market level facility and fee-for-service provider relationships with a focus on improving the provider experience and achieving enterprise network optimization goals. The position requires an in-depth understanding of how organization capabilities interrelate across the function or segment. The Director, Network Contracting and Support (Director, Contract Tools, Education, Processes) decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.
This role will be directly responsible for several key areas, including strategic direction and ongoing operational oversight of the contract governance committee (e.g. CSA), contract language review (e.g. NLRG), and the Merlin/iCertis teams. In addition, this role serves as the national subject matter expert for hospital/IDN contracting/negotiation principles and integrating new IDN.
- Responsible for the strategic development and implementation of operations, contract negotiations support, and business owner of Contract Strategy Approval Committee (CSA) and like governance processes
- Responsible for leading and overseeing National Language Resource Group (NLRG) team. Works collaboratively with the National Template team to ensure the latest template/language updates are being utilized by market teams
- Work collaboratively with senior leadership and multiple enterprise departments to drive best practices in facility, IDN and fee-for-service contracting
- Ensures the resolution of the development, expansion, and overall success of national contracting Key Performance Indicators and Best Practices
- Develops and maintains market tools and resources to support facility,IDN and fee-for-service contract negotiations
- Support expansion and usage of the Merlin/iCertis contract management system including collaborating with enterprise partners to ensure workflow optimization in the end-to-end contracting process
- Manage a team of 6-10 direct reports
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Use your skills to make an impact
Required Qualifications
- Bachelor’s Degree
- 5+ years of managed care market operations experience
- 2+ years of people leadership experience with the ability to work collaboratively and influence others
- 2+ years of strong project management skills with experience working on mid to large scale projects
- 2+ years’ hospital contracting negotiation experience and/or knowledge of facility payment/reimbursement methodologies
- Excellent communication skills, written and verbal
- Experience presenting to senior leadership
- Experience working successfully in a matrix environment
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