Director National Contracting - Waltham, MA

What does PHCS offer you?
Opportunity. Recognition. Satisfaction

You've worked hard to get where you are, but you're ready for bigger opportunities that expand your skills and enrich your career. At Private Healthcare Systems, you'll have them. As the national leader in health care cost management with a growing national customer base, we have been building a strong and stable organization for over 21 years. We work together to exceed customer expectations and take everything we do to the highest standards of which we are capable. That means always learning, always seeking challenge, always respecting one another, and always putting forth our best effort. We are proud of what we are building at PHCS, and proud of what we offer. If you join our team, you will be too.

Purpose of Position:

Provide leadership, strategy and project management expertise in the following key network services areas: National contracting for the following categories of healthcare providers: practitioners, ancillary providers, ancillary facilities and hospitals. Direct the activities and provide operational expertise to support Ancillary and Behavioral Health contracting and Network initiatives and projects on a company-wide basis.

Essential Functions:

General Responisbility:

Develop a successful team through effective selection, training, assessment, coaching and development of team members.

Develop, manage and monitor budget allocations.

Collaborate on special projects and task forces on a company-wide basis.

Comply and assure compliance with all governmental regulations and company policies.

NATIONAL NETWORK DEVELOPMENT RESPONSIBILITIES:

Manage a team responsible for:

Recruitment and management of national providers, including practitioner groups, IPAs, hospitals, ancillary and behavioral health providers.

Conduct ongoing assessment of the competitive position of PHCS National Ancillary and behavioral health networks and services and focus team on appropriate projects and business objectives.

Evaluate Strategic Business Plan for National Ancillary and behavioral health provider composition, competitive objectives and staffing requirements. Make recommendations for change and improvement based on evaluation. Coordinate with Director, Network Services and Territory Directors regarding approval and implementation of recommendations.

Ensure team has necessary tools, technical support, information and training needed to support the selection and ongoing evaluation of provider networks.

Evaluate National Ancillary and behavioral health credentialing standards required and recommend innovative solutions for meeting market conditions (e.g., rural markets).

Participate in the development and implementation of systems and procedures to continuously measure and improve network quality.

Actively seek opinion of PHCS payors with regard to the composition and quality of PHCS National Ancillary and behavioral health networks and propose appropriate revisions to current projects or future business plans.


Qualifications:

Required:

Bachelor's Degree or equivalent additional experience.

Six (6) + years minimum successful experience in network development, including contracting experience with all provider types, or comparable reimbursement activities.

Total of ten (10) years of related experience above Bachelor's degree level.

Minimum of four years management experience.

Proven leadership experience in professional environment; ability to motivate staff

Demonstrated knowledge of healthcare reimbursement methodologies.

Proven planning, organization, analytic and presentation skills Proficiency with PC applications and ability to utilize PC keyboard efficiently and accurately

PHCS offers a competitive salary and excellent benefits which include major medical, dental, 401(k), tuition reimbursement and a generous paid time off plan.

PHCS is an Equal Opportunity Employer. M/F/D/V


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