Assistant Director

Hospital for Special Surgery. in New York, NY

  • Type: Full Time
position filled

Overview

Assistant Director - PHO

Reporting directly to the Executive Director of the PHO, the Assistant Director will work closely and collaboratively with the Insurance payors as well as serve as a liaison to the medical staff and stakeholders.

RESPONSIBILITIES ::

  • Assisting in the Negotiation of physician managed care contracts, analytics and financial modeling.
  • Coordinating physician enrollment in managed care plans.
  • Insuring compliance of managed care companies with negotiated contracts.
  • Following up and resolving payment issues with payors.
  • Liaison between physicians and payors.
  • Scheduling, coordinating and documentation for all PHO related meetings.
  • Developing and managing budget for PHO.
  • Compiling information for membership regarding changes and updates in the reimbursement environment.
  • Participate in the development of HSS Alternative Payment Methodologies (ie: Episode Based Bundled Payments) to be offered to large employers and insurers.
  • Work with PHO Executive Director to develop strategies to sell Alternative Payment Methodologies to employers and insurers.
  • Collaborate with Employer and Strategic Partnership Department to create new product offerings to large employers.
  • EXPERIENCE, COMPETENCIES, AND PERSONAL CHARACTERISTICS :

  • Solid experience (minimum 5 years) in any combination of contract negotiations, resolving payment(claims) issues, financial analysis/planning for/in a hospital or Health Insurance company. Major teaching/surgical hospital experience or health plan experience is highly desirable.
  • Minimum of 5 years of supervisory, team-related experience is required.
  • Hospital Service Line experience highly desirable.
  • Technology savvy: excellent understanding of processes and databases; proficient with Excel, Word, and PowerPoint.
  • Demonstrated understanding of contract negotiations, finances, operations, regulations, strategic planning, and the hospital/healthcare industry, as well as external environmental forces, is required.
  • The ability to influence and motivate others, as well as work collaboratively within a multi-stakeholder environment is required.
  • EDUCATION:

  • Associate degree required
  • Bachelor’s degree preferred
  • Other Requirements

    #LI-AG1

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