Providence Health & Services Director, Payor Solutions in Renton, Washington
Providence St. Joseph Health is calling a Director, Payor Solutions to our location in Renton, WA.
We are seeking a Director, Payor Solutions to serve as the leader and the primary point of contact to facilitate partnership work streams, resolution for contract performance issues, develops action plans for issue resolution across the system for all Providence ministries and networks in support of the Providence strategic and financial plan. Assumes the leadership role in the identification of payment and policy changes, problem solving tactics and facilitates resolutions to attain goals. The Payer Solutions Director facilitates communication between PROVIDENCE Ministries/Networks and the health plan payers and/or providers in the problem resolution process. Works collaboratively with the SVP, Contracting, Executive Director, Operations, Executive Director, Analytics and the Executive Director, Contracting to identify and mitigate contract deficiencies and to identify reimbursement enhancement and/or cost reduction opportunities. Defines and implements processes for the successful implementation of payer and provider contracts, and contracting rev cycle improvements. Monitors contract performance for each health plan and provides feedback to negotiating teams to enhance contract performance and attain strategic and operational goals.
Essential Values-Based, Leadership and Management Competencies:
Demonstrates competencies in line with the four core values that are the foundation of all activities performed by management employees in order to achieve the Mission of the Providence.
Dignity: Demonstrates competence in communication, interpersonal relations and leading courageously.
Excellence: Demonstrates competence in continuous improvement, continuous learning, accountability, teamwork, motivating and developing others, problem-solving and decision making, displaying financial understanding, managing daily operations, and demonstrating business / job specific knowledge.
Service: Demonstrates competence in customer/patient focus, adaptability, and shaping change.
Justice: Demonstrates competence in community orientation, stewardship, and strategic planning and action.
In this position you will have the following responsibilities:
Provide Guidance to leaders to ensure strategic objectives are met related to the key payer partnership development at a system-wide level [12,000 contracts. $18b contracted services].
Consult with internal and external key stakeholders to identify issues related to payer contracts, financial performance and impact of payer policy changes.
Strategise with internal and external stakeholders to facilitate resolution, risks and then manage appropriate Contracting outcomes.
Oversee deliverables in partnership with internal and external stakeholders.
Report on performance to Contracting leadership and quantifies the changes/accomplishments delivered.
Strong, analytical and critical thinking skills to drive disciplined, fact-based decisions and executing with discipline and urgency
Attain and maintain detailed knowledge of the operations of other clinical and functional departments to be able to identify problems and effect solutions in relation to health plan issues.
Oversight of communications to payers related to payment policy changes and claims projects
Strong presentation, financial management and negotiation skills.
Identify and implement strategies to improve payer relations and better serve our patients, payors, physicians, departments and others by identifying and sharing best practices across ministries, networks, departments.
Ability to operate in and balance multiple accountabilities.
Bachelor's Degree in Business or healthcare management.
10 years contracting experience within a health plan, contract operations, project management and provider experience.
- Master's Degree in Business or healthcare management.
About the department you will serve.
Providence Shared Services provides a variety of functional and system support services for our Providence family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Non-Clinical Director/Executive
Req ID: 265806