CommonSpirit Health

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

System Director Payer Strategy

Threat Intelligence SpecialistSecurity AnalystFull TimeRemoteTeam 10,001

Location

United States

Posted

17 days ago

Salary

Not specified

No structured requirement data.

Job Description

This is a remote position that requires knowledge of the Payer or Provider landscape in the state of California. Assist with planning, directing, and implementing managed care objectives related to contract terms, reimbursement, negotiation, and key payer relationship management. Focus on significant payer relationships, negotiating various contract types across the organization's geographies and business lines. Gather and disseminate insight and strategic knowledge to and from relevant teams and departments across the enterprise. Secure favorable reimbursement and protect the interests of associated entities in contract negotiations. Strengthen relationships with significant payers. Guide critical payer negotiations and relationship management, impacting the organization's financial health and long-term strategic direction. Demonstrate expertise in contract dynamics and an understanding of payer landscapes. Effectively communicate complex insights to diverse stakeholders. Lead in the development of National Payer strategy, relationships, and contracts with assigned National Payers. Gather information and draft negotiation goal alignment with Division senior ministry leaders. Establish, build, and maintain positive, strategic interactions and relationships with assigned National Payer(s), employers, providers, and leaders across the ministry. Document ‘Lessons Learned’ sessions following each renewal with assigned National Payer. Engage in effective communication with internal stakeholders to ensure key contract terms and requirements are successfully implemented. Develop and execute communication plans related to payer relationships, negotiations, and organizational contractual obligations. Work with internal analytics teams to analyze and monitor financial aspects of existing managed care contracts. Gather feedback from ministry leaders on financial, revenue cycle, and operational issues related to contract renewals. Make independent decisions and/or exercise sound judgment based upon appropriate information and objectives.

Job Requirements

  • Bachelors Other or equivalent education and experience in payer strategy, managed care or provider network senior level role may be considered in lieu of degree.
  • Minimum of seven (7) years’ progressive leadership experience in the healthcare environment.
  • Five (5) years in managed care contracting for a hospital, healthcare system, or health plans in an intensive managed care market.

Related Job Pages

More Threat Intelligence Specialist Jobs

Brand Intelligence Analyst

PeakMetrics

PeakMetrics uses ML to extract insights and create actionable data from unstructured cross-channel media datasets.

Threat Intelligence Specialist17 days ago
Full TimeRemoteTeam 1-10H1B No Sponsor

Brand Intelligence Analyst translating online data into compelling brand stories

United States
$90K - $110K / year

Associate, Direct Response

AmeriCares

Americares is a global health and disaster relief organization that helps people and communities around the world access health in times of disaster and every day. Each year, Americares reaches 80 countries on average, including the United States, with life-changing health programs, medicine, medical supplies, and emergency aid. Americares is one of the world’s leading nonprofit providers of donated medicine and medical supplies. For more information, visit americares.org.

Threat Intelligence Specialist17 days ago
Full TimeRemoteTeam 51-200

Position Title: Associate, Direct Response Department: Development Key Relationships: Reports to: Associate Director, Direct Response Direct Reports: None Assignment Type: Full time Salary: $ 53,100 USD gross annually Benefits: Please refer to our Americares Careers page to see t...

United States

Professional, Operations Configuration Tester

MVP Health Care

MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

Threat Intelligence Specialist17 days ago
Full TimeRemoteTeam 1,001-5,000

This role involves testing and auditing health care claims and configurations to ensure accurate provider reimbursement and benefit plan requirements. Responsible for the accurate and timely testing of configuration required for provider reimbursement, adjudication rules, and ben...

United States

Benefits Technology Administration Manager

OneDigital

Fierce Advocates of Health, Success and Financial Security

Threat Intelligence Specialist17 days ago
Full TimeRemoteTeam 1,001-5,000Since 2000H1B Sponsor

As a Benefits Technology Administration Manager at OneDigital, you will be expected to lead a Benefits Technology team. This role has direct responsibilities for leading people, analysis, design and project management of new operational initiatives. Maintain a deep understanding ...

United States