Senior Director, Provider Contracting - Denver Health Medical Plan (Must Live in Colorado. Weekly On Site Requirement)
Core
Develop and implement provider contracts and agreements for Denver Health Medical Plan, negotiating payment terms and managing network recruitment.
Role type
Senior Director, Provider Contracting
Builds
Provider network agreements and contract management systems
Domain
Healthcare / Managed Care Administration
Required skills
Contract negotiation, financial modeling, regulatory compliance (Medicare/Medicaid), network recruitment, claims validation, team leadership
Preferred skills
Healthcare provider contracting experience, manager experience
Technologies
CPT, ICD-9/10, DRG, HCPCS, RBRVS, bundled payments, risk-sharing, provider capitation
Responsibilities
Oversee organizational contract development and management; Develop contract standards and payment terms; Evaluate rate proposals and reimbursement methodologies; Negotiate single case agreements; Manage recruitment of new providers; Participate in Joint Oversight Committee (JOC) meetings; Supervise and manage team performance
Seniority
Senior Director, strategic leadership & team management