Pediatric Health Network Director Contracting & Value Based Care

Location
Silver Spring, Maryland-Silver Spring
Posted
Jul 15, 2021
Closes
Aug 19, 2021
Ref
2100023G
Function
Executive, Director
Industry
Healthcare
Hours
Full Time
The Director of Contracting and Value-Based Care develops and manages the strategy for and relationships associated with payor contracts, network membership, and other partners on behalf of PHN. The Director participates in contract negotiations, ensures compliance and performance against contract standards, and leads ongoing communications with all relevant parties. The Director will report directly to the VP & Executive Director, PHN and serve in a matrixed position with CNH Managed Care / Payor Relations leadership.

The PHN Director of Contracting and Value-Based Care develops and executes the network's financial sustainability strategy leads the network's value-based portfolio, and monitors provider payments associated with contracts. The Director leads new business efforts on behalf of PHN and manages the team responsible for PHN provider relations, credentialing, and managed services.

Qualifications

Minimum Education
Bachelor's Degree Business, health care or related field (Required)
Master's Degree Degree in Business Administration, Finance, Hospital Management, or Healthcare Administration or commiserate experience strongly preferred. (Preferred)

Minimum Work Experience
10 years Experience in program administration and contracting (Required)

Required Skills/Knowledge
Knowledge of physician payment mechanisms, including development of value-based contracts and fee schedules.
Extensive experience in contract negotiations and tactics, with a focus on value-based contracts and fee schedules.
Strong creative and analytical skills around contract terms and options/ Ability to collect and analyze data, identify trends and institute operational changes.
Ability to develop new systems or procedures to resolve problems and facilitate workflow.
Exceptional oral and written communication skills.
Excellent interpersonal skills and proven experience working both independently and as an effective team member.
Extensive experience interacting effectively with all levels of employees, including executive staff, junior staff, and officials from external organizations.
Advanced working knowledge of contracting principles. Efficiency, diplomacy and composure in multi-tasking under pressure of multiple deadlines.
Demonstrate ethics and professional practices, as well as stimulate social accountability and community stewardship.
Demonstrate the ability to produce creative and innovative solutions and approaches to common issues.
Advanced technical competence in wide range of contracting and compliance issues; advanced legal knowledge in contract negotiations, especially as it pertains to value-based care; superior ability to manage relationships with vendors, staff, partners and regulatory agencies; highly experienced program development and problem solving techniques.

Functional Accountabilities
Vision and Strategy
  • Plan, implement, direct and evaluate PHN contracting and alliance opportunities at the strategic and operational levels.


  • Monitor department processes and seek opportunities to improve operations.

Contract Negotiation and Management
  • Implement strategic plan through scoping and execution of strategic alliances, partnerships and vendor contracts.


  • Compile and analyze data to support upper management decision-making.
  • Improve processes for efficiency and redefine procedures for timely response to proposals, awards and subcontracts while maintaining a high level of regulatory compliance.
  • Define, set, and utilize appropriate performance and quality measures for the department and for individual staff members.
  • Be seen as a leader of others, from forming a top team that will possess balanced capabilities to setting the mission, values and norms, as well as to hold the team members accountable individually, and as a group for results.
  • Conduct formal negotiations with sponsors and execute contracts with sponsors; write and negotiate subcontracts as required.
  • Obtain necessary internal clearances with regard to legal interpretation of proposals and contracts.
  • Work effectively with PHN and CNH Leadership, legal counsel, the Office of Innovation Technology Development, procurement, finance and other departments, as necessary.
  • Effectively communicate with PHN members, staff and partners about new initiatives, alliances, partnerships and contracts, including oversight for Provider Relations Manager and PHN Marketing.

Program and Services Oversight
  • Implement strategic plan through management of day-to-day operations of the department and value-based portfolio.


  • Ensure compliance with organizational and departmental policies and procedures, and regulatory standards.
  • See the potential in and understand the use of administrative and fiscal information resources and decision-support tools in process and performance improvement.
  • Compile and analyze data to support upper management decision-making.

Relationship Management
  • Assess, develop, manage and monitor existing partnership and potential partnerships that add value or align with the PHN vision and strategy.


  • Establish, build, and sustain professional contacts for the purpose of building networks of people with similar goals that support similar interests.
  • Oversee new business development and outreach, meetings and other engagements.
  • Work closely with PHN executive leadership to build, maintain and manage alliances, partnerships and vendor relationships.

Supervise
  • Provides day to day supervision of the contract administration and provider services staff, including assigning work load and overseeing the communications with the payers and the staff.


  • Responsible for evaluating the performance of the contract administration and provider services staff, providing coaching, guidance, and encouragement as well as any disciplinary actions, as required.
  • Set priorities for the staff to ensure projects are accomplished efficiently and on time.


Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law.

Similar jobs