Provider Contracting Director jobs in Utah

Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission. EO/AA

Under the direction of the Provider Network Director, the Manager of Provider Contracting is responsible for negotiation and renegotiation of provider contracts as well as ongoing evaluation, administration and monitoring of managed care and governmental payer agreements for facility, professional and ancillary services. The responsibilities are to perform contract development and negotiation/renegotiation to develop contracts that support the triple aim, are operationally and financially successful for the company, and support a stable and financial level of reimbursement in collaboration with our provider partners. This position monitors network adequacy and network performance. This position will work closely with all departments and providers throughout the state. The Manager of Provider Contracting must be highly collaborative and relationship oriented with a commitment to ACO concepts and goals.

Corporate Overview: University of Utah Health Hospitals and Clinics is an integrated academic healthcare system with five hospitals including a level 1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health Hospitals and Clinics is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million.

Responsibilities

Job Specific Responsibilities and Accountabilities

• Performs to required standards for job specific responsibilities and technical competencies.

Talent Management

• Hiring, training, developing, and communicating with staff.

Financial Management

• Responsible for developing, monitoring and achieving budget goals.

• Manages labor and non-labor expenses to budget or flex budget.

• Manages revenue to budget to maximize potential revenue.

EPE/Service

• Responsible for patient satisfaction scores within assigned area(s).

• Responsible for upholding PROMISE standards of direct reports and team members.

Quality

• Responsible to achieve quality goals for assigned area(s).

• Manages and promotes continuous process improvements in assigned area(s).

Performance Management

• Responsible to provide staff feedback on performance, including on-time appraisals and coaching.

• Responsible to deal with conflicts in a proactive manner and to reach resolution in a timely manner.

Building Relationships

• Forms positive relationships with staff, peers, and senior leadership to support the mission, vision, values, and performance standards of the organization.

• Actively engages staff with updates and news as well as involving staff in decisions and work teams. Provides feedback and recognition when appropriate.

Knowledge / Skills / Abilities

• Knowledge of principles and processes of hospital, physician and managed care billing practices and reimbursement methodologies.

• Demonstrated skills in contract negotiations including difficult and complex negotiations.

• Ability to establish credibility and develop collaborative relationships with hospitals, physicians, and ancillary providers.

• Ability to supervise, train and mentor staff and communicate effectively with staff, management, executives, and physicians.

• Strong organization, time management and project management skills and multi-tasking abilities.

• Advanced analytical skills and problem solving skills with the ability to formulate and communicate recommendations for improvement.

• Knowledge and application of English grammar including composition, editing and proofreading skills.

• Detail oriented.

• Knowledge of and experience with Medicaid and Medicare insurance programs.

• Knowledge of the Utah health community, including public and private entities and their role in the provision of health care to Utah residents.

• Knowledge of appropriate local, state, and federal regulations.

• Ability to work effectively, independently, and as part of a team.

• Demonstrated computer skills (including Excel, Word).

Qualifications

Qualifications Required

• A Bachelor's degree or equivalent related healthcare experience.

• A minimum of 5 years related healthcare experience in provider or payer relations, provider or payer reimbursement, and/or managed care contracting.

Qualifications (Preferred)

Preferred

• Master's degree in Health Care Administration, Business Administration, or related area.

• Previous management experience.

• Working knowledge of provider contract configuration related to accurate claims payment that reflects the provider agreement and intent.

• Experience with Epic as the provider fee schedule and claims payment system.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Listening, Manual Dexterity, Sitting, Speaking

Multi-lingual Candidates Welcomed

To inquire about this posting, email: careers@hsc.utah.edu

EEO Statement

University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who have experience working in settings with students from diverse backgrounds and possess a strong commitment to improving access to higher education for historically underrepresented students.

Individuals from historically underrepresented groups, such as minorities, women, qualified persons with disabilities and protected veterans are encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.

University of Utah Health Hospitals and Clinics, a part of The University of Utah, is an Affirmative Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran's status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both.

To request a reasonable accommodation for a disability, please contact the University of Utah Health Hospitals and Clinics Human Resources office at 801-581-6500.If you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity and Affirmative Action:

Sherrie Hayashi

Director/ Title IX Coordinator

Office of Equal Opportunity and Affirmative Action (OEO/AA)

383 University Street, Level 1 OEO Suite

Salt Lake City, UT 84112
801-581-8365
oeo@utah.edu
Online reports may be submitted at oeo.utah.edu/
For more information: https://www.utah.edu/nondiscrimination/

The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Hospitals and Clinics Human Resources at (801) 581-6500 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or Hospitals and Clinics Human Resources at (801) 581-6500 if you have questions regarding the post-retirement rules.

This position may require the successful completion of a criminal background check and/or drug screen.

Requisition Number 67816
Reg/Temp Regular
Employment Type Full-Time
Shift Day
Work Schedule Standard business hours
Location Name University of Utah Health Plans
Workplace Set Up Remote
City Murray
State UT
Department UIP CST 01H UUHP PROVIDER SRVC
Category Health Plans
Workplace Set Up Remote