Director, Provider Contracting - Community Health Choice
Harris Health System
Location: Houston, Texas
Type: Full Time
Internal Number: 156236
The Director of Provider Contracting provides strategic leadership in the development, direction, execution, and evaluation of an effective contracting program. The Director is responsible for assuring the program supports the delivery of quality providers appropriately and effectively, and that meets all contractual and regulatory requirements. This position develops and maintains a robust provider network that meets state-defined accessibility standards and incorporates continuous quality improvement and effective outreach programming. In addition, the Director develops systems to ensure effective coordination between network providers and contracting and ensures the analysis of utilization and cost data is translated to program implementation. Assures that network and contracting function are aligned with organizational strategic objectives and financial targets.
BA/BS degree. Four years equivalent work experience may substitute for degree requirement.
Seven years in healthcare, with at least five years experience in Providers/Managed Care Contracting.
Health Plan experience preferred.
Must have medical contract negotiations experience, preferably in Houston market.
Four years of direct supervision experience required
Contracting experience with both hospital and physician practice (group practice and solo practitioner) required.
Skilled at developing and implementing strategic objectives for the contracting function.
Experience with implementing provider incentive programs and pay-for-quality programs.
Experience with claims payment and CRM systems required. QNXT and Salesforce preferred.
Demonstrated ability to manage and develop staff in medical contract negotiation.
Analytical, Medical Terminology, Statistical, MS Word, MS Excel
Above Average Verbal (Heavy Public Contact)
Writing /Composing/Correspondence /Reports
Must have car and valid Texas Driver's license
Please be advised: Effective Wednesday, September 1st, 2021, with the exception of those who receive an approved exemption, all new hires must provide proof of vaccination against COVID-19 or receive the first dose of a COVID-19 vaccine by the second Friday of employment.
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.