Director of Network Management

DIRECTOR, CONTRACTING

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Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality care for patients across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. To learn more about AMSURG, visit www..

POSITION SUMMARY:

The Director, HPR Negotiations is responsible for securing and maintaining optimal reimbursement rates with health plan partners. Responsibilities include ensuring that the needs of facilities / entities, health plans and AmSurg are met by achieving annual assigned pipeline goals while establishing and maintaining positive business relationships.

Work Schedule: Remote

ESSENTIAL RESPONSIBILITIES:

• Negotiate initial or renewal contractual terms and reimbursement with designated market payers
• Manage multiple concurrent negotiation activities while leveraging strong project management skills to drive progress on specific market strategies to optimize reimbursement
• Create and maintain relationships between AmSurg providers and payers related to contracting
• Facilitate updating and maintenance of consolidated contract management system for accurate tracking of reimbursement terms and conditions.
• Establish regular communication and strong inter-Company relationships, while monitoring payer issues as they relate to provider participation, contract loading, payment issues in conjunction with Revenue Cycle team
• Assist in the development of departmental goals, executing projects to achieve these goals, and working closely with others within the HPR Department to continuously monitor Department performance
• Onboard acquisitions and new entities / locations to payer contracts as requested.
• Develop reports and presentations by collecting, analyzing and summarizing information and trends
• In collaboration with Vice President, analyze contract performance data, conduct onsite visits with payers, clients and centers that require market specific strategies.
• Ability to work in a matrix environment where multiple and competing customer demands are likely.
• Facilitate internal training or educational tools as they related to health plan contracting
• Position requires overnight travel up to 25% of the time
• Other Duties as assigned

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required.

• Strong negotiating skills with national/regional payors
• Solid understanding of payer contract language and multiple payment methodologies
• Ability to build relationships with providers, external vendors/payers and employees at all levels in the organization
• Strong organizational and written/verbal communication skills
• Excellent ability to manage to deadlines
• Demonstrated proficiency with financial reports, utilization trends, and patient mix based upon analysis of the data being tracked
• Experience working in a matrix environment where multiple and competing customer demands are likely
• Ability to work independently and with little supervision
• Ability to positively handle conflict
• Self-directed with a strong bias for action and urgency
• Experience working with health plans
• Must be fluent in Microsoft Office applications

Education/Experience:

• Bachelor’s degree with an emphasis in finance, accounting, or healthcare administration
• Six to ten years relevant experience in health care including managed care contracting, payment methodologies, contract language, contract negotiations and financial analysis
• ASC or hospital experience is strongly preferred
• Preferred experience: Project management, medical group operations, health plan operations, financial reporting and value-based contracting

Other Qualifications:

Must be able to handle multiple, simultaneous tasks effectively and efficiently while maintaining a professional, courteous manner. Must be able to work well with others. Strong verbal and written communication skills required. Must be detail oriented and organized. High integrity, including maintenance of confidential information. Must be able to exercise good judgment and positively influence and lead others, including handling confrontations with poise and efficiency. Based on business need, the ability to work a flexible schedule, including some evenings and weekends as approved in advance to meet contract renewal or expiration dates.

Employment at AMSURG: Living Our Values Every Day
At AMSURG, our values define who we are and how we serve our patients, partners, and each other. As a national leader in ambulatory surgery, we are committed to a culture of excellence, integrity, teamwork and caring deeply. Our values guide every decision, ensuring we continue to elevate healthcare and provide the highest quality care.
These guiding principles are the foundation of our culture and a guide to how we collaborate, innovate, and make a difference every day.

• Care Deeply for those around us.
• Cultivate Integrity to build trust.
• Champion Excellence for continuous improvement
• Celebrate Teamwork every step to the way.

Benefits:

To ensure we retain and invest in great people, AMSURG provides its employees with the benefits, recognition, training, and opportunities needed for professional growth. Our wide range of health and welfare benefits allow you to choose the right coverage for you and your family. AMSURG offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. Benefits offered include but are not limited to: Paid Time Off, Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs, and a matching 401(K) Plan.

Paid Time Off:

AMSURG offers paid time off, 9 observed holidays, and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.

EOE Statement:

AMSURG is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to age (40 or older), race, color, religion, gender, sex, national origin, pregnancy, sexual orientation, disability, genetic information or any other status protected under applicable federal, state, or local laws. We strive to also provide a disability inclusive application and interview process. If you are a candidate with a disability and require reasonable accommodation in order to submit an application, please contact us at: careers@. Please include your full name, the role you’re applying for and the accommodation necessary to assist you with the recruiting process.

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