Director of Payor Contracts - Legacy Community Health Services : Job Details

Be a part of driving healthy change in our communitiesAbout the Position

The Director of Payor Contracts at Legacy Community Health will be responsible for negotiating payor contracts and leading the contracting team in payor relations, credentialing, and privileging. You will also be responsible for developing a long-term payor contract strategy and lead Legacy's transition to value-based care agreements.

Key Responsibilities

Develop and maintain effective working relationships with insurance company and managed care company personnel responsible for contracting with healthcare providers

Negotiate managed care contracts including language, rates, amendments, etc. and monitor financial performance maximizing opportunities for net revenue improvement, volume/growth, and effectiveness of collection efforts

Develop contract structures that are in concert with the manner in which care is delivered, allow for costing of care in order to develop and negotiate adequate rates, are easy to administer, and make sense in relation to the size and exclusiveness of the contract

Analyze the significance and value of potential contracts; determine the cost of the care based on care delivery and contract structure; and project contract performance based on modeling of actual and representative samples

Monitor contract performance and other provisions to ensure compliance, identify problem areas, and resolve disputes

About Legacy Community Health

Legacy Community Health is a premium, Federally Qualified Health Center (FQHC) that provides comprehensive care to community members regardless of their ability to pay. Our goal is to treat the entire patient while improving their overall wellness and quality of life, in addition to providing free pregnancy tests, HIV/AIDS screening. At Legacy, we empower patients to lead better lives by promoting healthy behaviors and offering resources such as literacy classes, family planning services, and nutrition and weight management information.

Our roots began in 1981 as the Montrose Clinic, with specialization in HIV education, testing, and treatment. Since then, the agency has expanded to 10 clinics in Houston, one in Baytown, two in Beaumont, and one in Deer Park with extensive services that include: Adult primary care, HIV/AIDS care, pediatrics, OB/GYN and maternity, dental, vision and behavioral health. We also service students within KIPP and YES Prep schools. Legacy is committed to driving healthy change in our communities.

Requirements

Bachelor's Degree in Accounting, Business Administration, or Finance

5 years of progressively responsible managed care contracting experience in a payor or healthcare setting

3 years of experience in a medium to large health system

Benefits

• Medical, Dental, and Vision insurance
• Long-Term Disability insurance
• Life insurance and AD&D
• 403(b) retirement plan
• Employee Assistance Plan
• Subsidized gym membership
• 24-hour travel assistance
• Paid Time Off
• PTO Exchange Program
• Company holidays (9 days + 1 floating day)
• Bereavement Leave
• And more

Legacy Community Health is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace.#J-18808-Ljbffr