Director, Payor Contracting

Job Locations US-FL | US
Job Post Information* : Posted Date 1 month ago(9/15/2021 1:06 PM)
ID
2021-1582
# of Openings
1
Career Area
Management

Overview

Director, Payer Contracting

 

This is a fulltime opportunity. 

 

Job Location: Florida preferred; will consider remote options 

 

Novocardia is on a mission to empower clinicians across the United States to consistently deliver higher-quality, prevention-focused, patient-centered care, and enable clinicians to be rewarded for focusing on these services for their patients, and delivering care now that avoids more advanced disease down the line.  

 

We are seeking a talented and experienced individual to join our growing team as Director, Payer Contracting.  This role affords a singular opportunity to work closely with a world-class team to help build a disruptive, mission-driven, physician-led clinical delivery organization from the ground up! 

 

Chronic disease is the dominant cause of avoidable healthcare spending and death in the United States and worldwide.  Fortunately, much of this disease burden and associated spending is potentially avoidable through delivery of more proactive, prevention-focused care.  Our founding team has decades of experience in clinical medicine, payer and provider leadership, government, data science, and clinical operations.  We are deeply passionate about improving care quality, and providing more Americans with access to great, evidence-based chronic disease care. We are also deeply committed to building more sustainable and durable payment models for this care – models that reward clinicians for delivering the right care, in the right place, at the right time.  

  

We are looking for high integrity, mission-oriented people who are passionate about improving the quality and value of chronic disease care in America, excited to join a dynamic, rapidly-growing, and diverse team, and want to build a disruptive, world-class business.  We are humble, ambitious, learning-oriented, focused on execution, and all in on this venture and vision.  Come join us!

 

 Overview 

 

The Director, Payer Contracting is a critical member of a fast-paced, interdisciplinary team responsible for driving targeted network building and payer contracting with the goal of establishing optimal provider risk agreements. This role will be responsible for preparing, negotiating, and maintaining Novocardia’s payer contracts tied to  fee-for-service (FFS) and fee-for-value (FFV).

Responsibilities

Primary Responsibilities

  • In partnership with operations and contracting leadership, pitch and present Novocardia’s clinical value proposition to payers and negotiate FFS and FFV payer contracts that support Novocardia’s goals and values
  • Partner with analytics team to determine the feasibility of FFV contract success; apply analyses to negotiation strategy and tactics as needed
  • Ensure contracts are implemented, audited, and renegotiated in a timely manner; lead resolution of contract issues
  • Review existing contracts and identify opportunities for improvement consistent with Novocardia’s goals and values
  • Partner with operations and contracting leadership to develop strategies and initiatives for payer contracting and develop a “Novocardia playbook” for payer contracting
  • Oversee maintenance of database of payer contracts 
  • Develop and cultivate strong and effective working relationships with payers (including local health plan representatives) and drive continuous improvement of communications and operational efficiency

Qualifications

Qualifications

  • Bachelor’s degree in finance, economics, public health, health administration, business administration, public policy, or related field
  • Minimum of 7 years contracting/negotiations experience involving payers and complex delivery systems
  • Understanding of health care pricing and reimbursement methodologies (preferably complex reimbursement models, including incentive-based models), network development processes, and contract language
  • Experience developing and managing key payer relationships
  • Experience identifying, developing, and cultivating strong relationships with payer partners
  • Understanding of and experience with managed care and business models associated with different types of provider organizations (single specialty, multi-specialty, hospital, CIN, IPA etc.)
  • Team player; ability to communicate effectively, work directly with partner practices, physicians, staff, department leads, and health plans, and develop strong working relationships within a fast-paced, matrixed organization
  • Knowledge of principles of negotiation and superior problem solving, decision-making, and negotiating skills
  • Proficient in Microsoft Office, including Excel and PowerPoint

 

Novocardia provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to religion, race, creed, color, sex, sexual orientation, alienage or citizenship status, national origin, age, marital status, pregnancy, disability, veteran, or military status, predisposing genetic characteristics or any other characteristic protected by applicable federal, state, or local law. 

 

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