Director of Professional Contracting
Job ID: R0039993 | Health Services Leadership | Full Time | Charlottesville, VA
The Director of Professional Contracting will be responsible for the day-to-day oversight of UVA Health's professional managed care contracting function.

This position is a senior-level position within UVA Health's Managed Care Contracting team. Among other things, it is responsible for:
  • Oversight of third-party payor managed care contracting activities on behalf of UVA Health's professional providers, including development, negotiation, implementation, monitoring, and management of all third-party payer contracts.
  • Management of the contracting process and all documentation related to rate structures, addendums, internal approvals, and language requirements.
  • Acting as a liaison for the efficient communication and coordination of day-to-day Managed Care operational issues related to patient access, claims adjudication and collection, and medical care management.
  • In conjunction with others within UVA Health, including the Managed Care Contracting workgroup, developing and executing payer contracting strategy for fee for service and value-based risk agreements.
  • Developing and advancing new managed care contracts and relationships with all third-party payers.
  • Evaluating, monitoring, and maintaining existing managed care contracts.
  • Assisting with the development of future value-based payment agreements and risk-based contracting strategies, including tracking and monitoring risk-based contracts performance, and coordinating with population health, quality, and others to use managed care contracts to improve system efficiency, quality, and financial performance.
  • Facilitating the financial analyses and contract language negotiations necessary to support the accuracy and financial performance of fee-for-service and value-based managed care contracting initiatives.
  • Fostering relationships with managed care organizations in order to develop new business opportunities and partnerships.
  • Soliciting input and coordinating initiatives with cross-functional teams, including administration, marketing and communications, finance, revenue cycle, and population health.
  • Maintaining knowledge and understanding of the current trends and developments in healthcare reimbursement and payer strategy, including keeping abreast of new business opportunities, regulations, standards, and directives regarding governmental/third-party agencies (Medicare & Medicaid) and other third-party payers.
  • In conjunction with other members of the Managed Care Contracting team, participating in the development, communication, and implementation of financial and operational requirements of third-party payer agreements.
  • Making strategic recommendations regarding payer contracting based on assessment of market opportunities and how they impact UVA Health.
  • Developing and maintaining a network of relationships with third-party payers.
  • Developing the strategy, objectives, techniques, and tactics to achieve the strategic goals of the department.
  • Other duties as assigned by Chief Managed Care Officer for UVA Health.

Position Compensation Range: $109,116.80 - $174,595.20 Annually

MINIMUM REQUIREMENTS
  • Education: Bachelor's degree. Master's degree preferred.
  • Experience: Ten years of healthcare experience, to include knowledge of the principles of managed care contracting sufficient to direct professional staff and coordinate all applicable aspects involved with requirements of managed care contracting. Working knowledge of federal and state healthcare insurance laws and regulations. Experience with value-based contracting and government payer programs is preferred.
  • Licensure: None.
  • Knowledge and Skills: Basic knowledge of and experience utilizing a personal computer. Intermediate word processing and spreadsheet skills required.

PHYSICAL DEMANDS:
This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings and programs.



COVID Vaccination Requirement and Guidelines

 

Please visit the UVA COVID-19 Job Requirements and Guidelines webpage prior to applying for current information regarding vaccination requirements and guidelines for employment at UVA.

 

 

 


Charlottesville, VA
Charlottesville, VA 22903

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