Director of Payor Contracting presso InterMed
InterMed · South Portland, Stati Uniti d'America · Onsite
- Senior
- Ufficio in South Portland
Reporting to the Chief Financial Officer, the Director of Payor Contracting leads the development, negotiation, and management of all health plan agreements to optimize reimbursement and support the organization’s strategic and financial objectives. This role serves as the primary liaison with payors, overseeing contract performance, revenue integrity, compliance, and issue resolution. The Director partners closely with physician leadership and senior executives to design and execute a comprehensive contracting strategy that advances the organization’s growth, sustainability, and value-based care initiatives.
ESSENTIAL FUNCTIONS:
Leadership:
- Develop and execute a comprehensive Contracting Plan in alignment with
- InterMed’s strategic plan, supporting the organization’s philosophy that “Care drives payment.”
- Advance reimbursement models that reinforce high-quality, patient-centered care and support practice-based care management and population health initiatives.
- Design and maintain structures that enable the organization’s success in shared savings and value-based arrangements, ensuring readiness for evolving payment models.
- Align contracting strategies with InterMed’s on-site employer clinic initiatives, in partnership with the Director of Workplace Health, to enhance community- based care delivery.
- Build and sustain strong relationships with representatives of all participating payors, including commercial, Medicare Advantage, and other strategic partners.
- Collaborate with clinical leadership, including the Director of Clinical Care Transformation and the Medical Director of Clinical Systems, to integrate clinical quality and care management objectives into payor agreements.
- Foster a high-performance team culture, promoting accountability, collaboration, and professional growth across the contracting function.
- Serve as a strategic change leader, driving continuous improvement and innovation in how InterMed delivers and is reimbursed for care.
- Provide effective team leadership, including clear direction, regular feedback, and ongoing performance and development planning. Implement improvement plans as needed to ensure team effectiveness and goal attainment.
Communication:
- Act as the primary liaison between InterMed and all payor partners, ensuring clear, consistent, and professional communication to support contractual and strategic objectives.
- Foster strong cross-functional relationships with senior leadership and key stakeholders to drive alignment, collaboration, and timely execution of contracting initiatives.
- Demonstrate exceptional interpersonal skills, building trust and credibility with colleagues, payors, and external partners across diverse settings.
- Navigate complex situations with diplomacy and tact, maintaining positive working relationships and effectively resolving conflicts while advancing organizational goals.
- Translate complex contracting and financial information into clear, actionable insights for internal stakeholders to inform decision-making.
Contracting:
- Partner with the CFO and senior leadership to develop a multi-year contracting strategy, ensuring alignment with organizational goals and preparing recommendations for approval by the CEO, Finance Committee and Board of Directors.
- Leverage advanced analytics and data-driven insights, in collaboration with the Business Intelligence team, to evaluate proposed contract terms, identify risks and opportunities, and ensure compliance with existing agreements.
- Support the annual budgeting process by providing revenue projections, scenario analyses, and financial recommendations based on contract performance and anticipated payor trends.
Operations and Quality Improvement:
- Coordinate with the Operations team to align quality improvement initiatives with contractual obligations, ensuring organizational goals are met and commitments to payors are consistently fulfilled.
- Collaborate with the Chief Medical Officer and Medical Director of Clinical Systems to ensure all contract terms support the company’s care management plans and ongoing compliance with existing health plan agreements.
- Engage with the Quality Improvement Committee and clinical task forces to integrate operational, clinical, and contractual priorities, driving continuous improvement in both patient care and organizational performance.
JOB REQUIREMENTS:
- Bachelor’s degree in Business, Legal, or Health Care Administration field; graduate degree preferred.
- 5-10 years of healthcare contracting experience required.
- Experience leading high-functioning teams in a healthcare environment.
- Experience developing strategic plans and implementing key components of these plans on time and within approved budgets.
- Ability to prioritize, organize, and plan work independently.
- Ability to communicate and work effectively with all levels of employees within an organization.
- Excellent communication skills: listening, oral and written.
- Proven record of success working in a collaborative manner with physicians is preferred.
InterMed is an equal opportunity workplace and prohibits discrimination or harassment of any kind. We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, gender identity and/or expression, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law.
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