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 ensuring compliance with state and federal regulations.
Role type
Senior Director, Provider Contracting
Builds
Provider network agreements and reimbursement models
Domain
Healthcare / Managed Care
Required skills
Contract negotiation, Financial modeling, Regulatory compliance (Medicare/Medicaid), Network recruitment, Claims validation, Team leadership
Preferred skills
Healthcare provider contracting experience, Managerial experience in healthcare
Technologies
CPT, ICD-10, DRG, HCPCS, RBRVS
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 members
Seniority
Senior Director, strategic leadership & team management
