Providence Renton Jobs

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Providence Executive Director of Contracting - Clinical Institutes in Renton, Washington

Description:

Providence is calling an Executive Director to lead contracting across the health system for our clinical institutes.

THE ROLE

The Executive Director of Contracting is responsible for partnering with leaders in the Clinical Institutes providing tactical direction for contracting through collaboration with Market Contracting teams. Consults with and advises the appropriate executive staff on issues, events. Also presents action plans to ensure objectives are met. The Executive Director, Clinical Institutes facilitates communication between Providence departments, and between the Providence Ministries/Networks and the health plan payers in the problem resolution process. Works collaboratively with the SVP, Contracting, Regional Vice Presidents, Executive Directors Contracting and Analytics, and Sr. Contract Managers/Contract Managers to identify and mitigate contract deficiencies and to identify reimbursement enhancement opportunities. Monitors contract performance for Clinical Institutes for each health plan and develops reimbursement strategies in collaboration with 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. (See below for attached list of behavioral definitions):

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.

ESSENTIAL FUNCTIONS:

  • Serves as the Executive presence between Contracting and the Clinical Institutes

  • Facilitates the review of negotiated payer contracts for Providence for the Clinical Institutes by working with appropriate functional departments in support of the Providence strategic and financial plan.

  • Maintains strong, analytical and critical thinking skills to drive disciplined, fact-based decisions and executing with discipline and urgency

  • Maintains strong financial management and negotiation skills.

  • Identifies and implements reimbursement strategies to improve payer relations and better serve our patients, payors, physicians, Clinical Institutes and others by identifying and sharing best practices across ministries, networks, departments.

  • Maintains the ability to operate in and balance multiple accountabilities.

  • Helps develop and set overall reimbursement strategy for the specialty care working with the contracting team and for with each payer.

  • Provides leadership in analytics and performance measurement to help refine and monitor reimbursement strategy.

  • Works closely with the Clinical Institutes and Market Contracting Leaders to identify and implement Centers of Excellence approvals with payers.

  • Works collaboratively to identify specialty bundle opportunities.

  • Maintains a solid understanding of entire operational workflows around reimbursement and contracting for specialty services.

  • As this position is deeply imbedded in pillar discussions specialty services, helps set strategy and escalate as needed.

  • Supports contract and reimbursement modeling to support service line expansion and develop activities.

  • Maintains involvement in contract compliance activities to enhance potential optimization efforts.

  • Treats all information and data within the scope of the position with appropriate confidentiality and security.

  • Follows all policies developed by the Information Systems Department to support change management, confidentiality, and security.

  • Respects the dignity, confidentiality and privacy of patients.

  • Maintains organizational, employee, and patient confidentiality at all times.

  • Cooperates fully in all risk management activities and investigations.

  • Reports promptly any suspected or potential violations to laws, regulations, procedures, policies and practices, and cooperates in related investigation.

  • Conducts all transactions in compliance with all company policies, procedures, standards and practices.

  • Demonstrates knowledge of all applicable compliance and legal requirements of the job based on the scope of practice of the position.

Qualifications:

Required qualifications for this position include:

  • Bachelor’s Degree in Business or healthcare management

  • More than 12 years health plan contracting experience for Ambulatory Surgery Centers experience required.Minimum 10 years of leadership experience in managed care.

  • A minimum of 12 years health plan contracting experience.

  • An experienced business leader with a minimum of 10 years of experience with managed care operations and the delivery of health care to patients in outpatient and inpatient settings.

  • Thorough understanding of contract negotiations strategies and implementation of negotiation strategies.

  • Possess detailed understanding of use of contract management systems within a managed care environment.

  • Strong influencing skills with the ability to facilitate and lead project teams around reimbursement and problem solving skills.

  • Strong time management skills and the ability to adapt to shifting priorities.

For information on our comprehensive range of benefits, visit:

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

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.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. 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.

Schedule: Full-time

Shift: Day

Job Category: Health Care

Location: Washington-Renton

Req ID: 270930

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