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Director of Provider and Facility Contracting

Job Title
Director of Provider and Facility Contracting
Job ID
27647381
Location
Conroe,  TX 77304
Other Location
Description
The Director of Provider and Facility Contracting is responsible for facilitating provider and facility contracts for the organization.  This position analyzes the financial impact of contracts and terms, maintains contracts and documentation within a tracking system, and advising leadership on matters of significance.

Essential Duties and Responsibilities include the following. 
  • Manage contracts with all payers, e.g., insurance companies, IPAs, TPAs and government programs.
  • Facilitate payer contract documents from pre-contract through signature.
  • Responsible for the accuracy of supporting documentation for contracts and completing documents accurately.
  • Develop and maintain processes that provide timely notification of critical contract events (e.g., renewals, termination and due dates contained within the agreements); ensure contractual language is kept current.
  • Evaluate fee schedule on a yearly basis to identify possible opportunities for additional covered services, medical policy changes and reimbursement.
  • Supervise credentialing staff, ensuring accuracy of provider and facility enrollment and maintenance of plan directories with each payer.
  • Work with operational staff to develop action plans necessary to accomplish organizational goals.
  • Coordinate and communicate contractual terms to the billing and finance departments.
  • Ensure staff is informed of changes in medical policy and billing policies.
  • Conduct on-going assessments of assigned networks and make recommendations for strategic initiatives, goals, and objectives.
  • Develop and maintain periodic, e.g., bi-weekly, reports on the status of all contracts.
  • Assure accurate data entry of contract specifications and terms into database and completeness of all contracting processes.
  • Assist Revenue Cycle Leadership team with payer issues as directed.
  • Maintain excellent written and verbal communication with all internal and external customers.
  • Effectively and professionally represent LSFHC to the payer community.
  • Assist with all contracting administration and projects, as needed.
Required Job Qualifications:
Bachelor's degree in Business Administration, Healthcare, or other relevant field required. 
Three (3+) years of relevant contracting experience with hospital, clinic, physician, and/or primary care and health system.

 

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