Sr. Director, Payor Contracting

Company:

AHI agilon health, inc.

Job Posting Location:

Remote - USA

Job Title:

Sr. Director, Payor Contracting

Job Description:

Under the supervision of the SVP, the Director, Payer Contracting is responsible for end to end contract administration, ensuring that agilon’s payer contracts meet internal and external requirements, are executed and renewed on a timely basis and managed effectively to support agilon and our physician group partners’ achievement of overall growth and profitability goals and to minimize risk Serves as a SME to the Market President and market team regarding payer contract details and overall payer relationship.

Essential Job Functions

• Leads the Contract Ops team. Ensures Sharepoint payor contract files are accurate and up-to-date. Approves contract summaries as entered into Contract DataBase by Contract Ops.
• Prepare contract briefs and revisions summarizing contractual requirements and budgets to support internal Company knowledge of payor contract terms.
• Participates in regular Payer Strategy/Update sessions with Company Market Team members and physician group partner leaders. Supports new payer contract implementations with Company Market team members and health plan ensuring that contract terms are appropriately implemented.
• Supports ongoing local JOC meetings, issue resolution and other relationship needs between Company market team and payers.
• Collaborates with the Payor Contracting VPs, in support of language review and further development of PADU, manages key legal projects related to language development and risk management
• Manages the required negotiation contract approval process ensuring that document packages are accurate, complete and executed correctly and on time.
• Supports SVP Payor Contracting in management of projects initiatives, including but not limited to, Quality, Termination time lines and inventory by Health Plan of sub-optimal language terms
• May negotiate renewals and or support VPs of Payor Contracing with renewals and new market implementations
  
  

Other Job Functions:

• Understand, adhere to, and implement the Company’s policies and procedures.
• Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded.
• Take personal responsibility for personal growth including acquiring new skills, knowledge, and information.
• Engage in excellent communication which includes listening attentively and speaking professionally.
• Set and complete challenging goals.
• Demonstrate attention to detail and accuracy in work product.
• Occasional travel required. 10% - 20% on average
  
  

Required Qualifications:

Minimum Experience

• 5+ years’ progressive experience negotiating HMO/ PPO risk agreements. . Medicare Advantage experience preferred.
  
  

Education/Licensure:

• Bachelor’s degree required, Masters preferred.
  
  

Location:

Austin, TX

Pay Range:

$153,000.00 - $191,300.00

Salary range shown is a guideline. Individual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.