Director Payor Relations Contract-SWHR
Director Payor Relations Contract-Southwestern Health Resources-Clinically Integrated Network (SWHR-CIN)
At Southwestern Health Resources (SWHR), we believe healthcare can be more integrated, accessible, and affordable for all. Our purpose is simple yet powerful: to build a better way to care, together. SWHR is a patient-centered, clinically integrated network that brings together academic and community clinicians, researchers, hospitals, and ambulatory facilities. We partner with physicians to drive a new model of value-based, high-quality, data-driven healthcare—serving everyone in the communities we touch.
By combining the strengths of UT Southwestern Medical Center and Texas Health Resources, we’ve built the largest provider network in North Texas, giving our team members the opportunity to make a meaningful impact at scale. Healthcare in the U.S. is evolving rapidly, and SWHR is committed to leading that change—moving healthcare forward, together.
Position Summary
Provides administrative guidance and operational management of SWHR payor agreements which may include, but not limited to, facility, ancillary and physician agreements or specialty agreements such as transplant, ACO and bundled payment. Develops and implements payor contracting strategies. Maintains an advanced understanding of financial analytics. Develops communication materials and maintains relationships with internal stakeholders and payors.
· Work location: Southwestern Health Resources Headquarters, Farmers Branch, TX.
Position Duties
Conducts and successfully completes, in a timely manner, contract negotiations with payors that meet or exceed the financial and operational objectives of SWHR and SWHR affiliated providers. Proactively enlist legal, operational, and financial input and support to achieve maximum benefit for SWHR and SWHR affiliated providers.
Identifies and develops new business opportunities through pursuing payor contracts. Coordinates and prepares marketing collateral materials, research new products and payor offerings, identifies prospects for SWHR programs and services. Develops and maintains positive business relationships with third party payers.
Requests, reviews and understands financial analytics in support of contract negotiation, contract performance and planning activities. Maintains a thorough understanding of contract language and its implications on SWHR contract performance and obligations.
Monitors performance of contracts, regarding their financial performance, volume trends, product implementation, and acts as liaison between internal stakeholders and payers.
Coordinates SWHR's interaction with other affiliated organizations contracting staff. Keeps up to date with industry trends, payor trends and overall market trends.
Develops and implements policies and procedures for operation of unit.
Serve on, attend, and participate in SWHR committees, meetings, and functions as requested.
Performs other duties as assigned.
Education
Bachelor's Degree in Business Administration, Health Care Administration, or related field required
Master's Degree preferred. In lieu of degree, and additional 4 years of experience is required.
High School diploma and an additional 4 years experience required
Experience
8 years experience in contracting and business solutions in health care environment, to include significant managed care contracting experience required
12 years experience required without a degree
Skills
Excellent negotiating skills.
Excellent analytical skills.
Excellent oral and written communication skills.
Working knowledge of personal computer applications, including word processing, spreadsheet applications, graphics, publisher, and database software.
Familiarity with DRG, HCPCS, CPT, and ICD-9 coding.
Ability to manage multiple priorities and deadlines.
Why Southwestern Health Resources
As a Southwestern Health Resources you’ll enjoy: comprehensive benefits, including a 401(k) with match; paid time off; competitive health insurance choices; healthcare and dependent care spending account options; wellness programs to keep you and your family healthy; tuition reimbursement; a student loan repayment program; and more.
Explore Southwestern Health Resources Careers for more information and to search all career opportunities.
Let’s move healthcare forward – together.
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