Director Payer Contracting

Job Details

This role is responsible for leading payer contracting strategies and managing key relationships with health plans to optimize reimbursement, strengthen financial performance, and support the Enterprise's mission of delivering high-quality, accessible care. This position serves as a critical link between the Enterprise and its payer partners, ensuring that managed care agreements align with organizational goals for growth, value-based care, and operational excellence.

Job Description

• Executes the process to complete required payer contracts/amendments /renewals as assigned.
• Meets independently with peers and payers to further organizational objectives.
• Makes recommendations on financial terms and contract language by collaborating with Payer Analytics, Legal and other internal stakeholders to create comprehensive rate proposal/impact deliverables (includes financial analysis, contract language/redline).
• Ensures complete and accurate implementation of all fully executed contract documents.

Education and Experience

• Bachelor’s Degree in Business, Health Administration, Finance, or related field, required.
• Master’s Degree Business, Health Administration, Finance, or related field, preferred.
• 5 years progressive experience in managed care contracting or payer relations within a complex healthcare
  organization, required. and
• 5 years Proven success in negotiating payer agreements, developing reimbursement strategies, and managing payer
  relationships, required.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University Hospitals, Inc.

Primary Location Address

1101 Market, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students.