Director, Provider Contracting

Altais is on a mission to improve the healthcare experience for everyone by supporting physicians with technology and team-based care. The company includes a network of physician-led organizations across California, aiming to build a stronger healthcare system.

Location: Canada

Salary: $154,500 - $185,400/year

Responsibilities

• Identify, develop, and implement corporate contracting strategies, business opportunities, and methodologies for contract negotiations, stabilizing health care costs and/or decrease expenses to remain within company budget
• Develop and maintain strong working relationships with key hospitals and network providers
• Manage complex contracting and negotiations for fee for service and value-based reimbursements with network providers (e.g. Hospital systems, ancillaries, and large physician groups)
• Perform analysis independently and coordinate with the Finance Division to review financial performance and healthcare costs of provider contracts
• Lead complex contract implementations as well as identify and resolve issues around contracts
• Create and manage value-based contracting incentives and reimbursement methodologies that are quality and performance based
• Lead in resolving elevated and complex contractual issues with internal and/or external customers
• Participate in external provider meetings and internal operational meetings to continuously improve relationships, processes, operations and best practices
• Oversee the development of accurate and timely internal communication around new and renewed managed care arrangements
• Develop, evaluate, and interpret contract language terms to ensure language is consistent with company policies and applicable regulatory agencies
• Oversee all contract template revisions, partnering with Compliance and Legal to ensure templates are up to date
• Create and oversee all departmental and organization resource material applicable to Provider Contracting, i.e. Policies and Procedures, Provider Manual
• Train contracting team on operational changes, department updates and upcoming projects

Requirements

• Bachelor's degree from an accredited 4-year university or equivalent coursework or experience in managed healthcare related field. Master's preferred.
• 10+ years professional managed healthcare administration experience, with 5+ years people management experience in healthcare / contracting positions
• Experience working in IPA / managed care setting
• Strong financial acumen with proficiency in analyzing and interpreting financial trends
• Proven contract preparation skills, with knowledge of Medicare, Medi-Cal, PPO, HMO Commercial lines of business, various reimbursement methodologies and value-based contracting

Benefits

• Excellent medical, vision, and dental coverage
• 401k savings plan with a company match
• Flexible time off and 9 Paid Holidays
• Participation in annual bonus program

Additional Information

• The Base Salary for this position is $154,500 - $185,400/year
• Additional compensation and benefits are provided, including a robust benefits package and bonus opportunities.
• The role requires compliance with background checks and legal considerations.
• The position emphasizes company values such as Compassion, Community, Leadership, Excellence, and Agility.