Astrana Health қауымдастыққа бағытталған медициналық клиникаларды алғашқы медициналық-санитариялық, шұғыл және бірнеше мамандандырылған медициналық көмекті үйлестіруге арналған медицина қызметтерін көрсетушілерге арналған технологиялық платформамен біріктіреді. Оның қызметтері пациенттерге желі ішіндегі клиницистермен байланысуға көмектесіп, медицина қызметтерін көрсетушілерді медициналық көмекті үйлестіру және алдын ала рұқсат алу процестеріне арналған құралдармен қамтамасыз етеді. Клиникалық операцияларды медициналық командалар үшін әзірленген технологиямен ұштастыра отырып, Astrana Health медициналық көмекке қолжетімділікті, пациент тәжірибесін және күнделікті медициналық қызмет көрсетуді жақсартуға назар аударады.
Director of Hospital Contracting, California
Lead hospital and health system negotiations for Astrana Health’s California managed care network. Improve reimbursement, risk arrangements, network access, and financial results.
Америка Құрама Штаттары
Калифорния135 000 $ – 160 000 $ / жыл
АраласТолық жұмыс күніЖетекшіҚажетті Тіл: ағылшын тіліДиректорСипаттама
- Work with the VP of Contracting to shape and carry out hospital contracting strategy across the organization
- Direct negotiations and partner relationships with hospitals, integrated delivery systems, academic medical centers, and other facility providers
- Advance contracting plans that support network growth, market competitiveness, affordability, and financial performance
- Assess hospital utilization, reimbursement models, and financial results to inform negotiation strategy
- Negotiate complex agreements covering inpatient, outpatient, behavioral health, post-acute, and ancillary services
- Oversee DOFR agreements, hospital amendments, Letters of Agreement, and corrective action plans
- Review contract terms, reimbursement structures, risk allocations, and regulatory obligations
- Act as the main escalation contact for hospital and health system contracting matters
- Coordinate with Finance, Network Management, Operations, Claims, Configuration, and Business Development to implement contract terms
- Track contract results, find rate improvement opportunities, and address network access or financial performance issues
- Contribute to value-based and risk-sharing programs with hospital systems and facility partners
- Develop analyses and recommendations on hospital network strategy, reimbursement patterns, financial impact, and market opportunities
- Guide and develop contracting staff, and manage contract workflows and negotiation priorities
- Carry out other assigned duties
Талаптар
- Bachelor’s degree in business administration, healthcare administration, finance, or a related discipline; equivalent experience may be considered
- At least five years of healthcare contracting experience, including substantial direct negotiation with hospitals or health systems
- Background negotiating managed care agreements and risk-based contracts
- A record of successful negotiations with hospitals and health systems on managed care agreements
- Strong knowledge of hospital reimbursement approaches, including DRG, per diem, case rate, APC, carve-out, and value-based payment models
- Experience leading projects and teams in a managed care, health plan, MSO, IPA, or provider organization
- Experience with delegated risk, capitation, Restricted Knox-Keene (RKK), dual risk, global risk, MSSP, ACO, or other alternative payment arrangements
- Ability to assess financial models, contract terms, and reimbursement structures to support negotiations
- Knowledge of California managed care contracting and delegated healthcare models
- Advanced skills with Microsoft Excel, Word, and PowerPoint
- Experience using EZ-CAP or a comparable healthcare administration and managed care platform
Артықшылықтар
- Hybrid schedule combining office and home work each week
- Equal opportunity and affirmative action employer
- Reasonable accommodations are available to applicants with disabilities