Director, Payor Relations
Location:
Calmont Operations Building
Department:
Payor Relations
Shift:
First Shift (United States of America)
Standard Weekly Hours:
40
Summary:
The Director of Payor Relations is responsible for developing and maintaining meaningful and effective relationships with managed care organizations and internal staff with the goal of securing, managing, and renegotiating viable, revenue generating health care service contracts on behalf of CCHCS entities and providers with both commercial and government funded managed care organizations. The Director will manage payor intelligence, contract implementation and validation as well as oversee issues and follow up on contract related claims issues.
Qualifications:
- Bachelor's degree preferred.
- At least ten (10) years of operational experience in a manage care setting required.
- Extensive experience in contract negotiation and payor relations required.
- Superior knowledge of medical terminology.
- Must be able to foster and maintain healthy relationships with outside payors. Must have a clear understanding of the intricacies of commercial, state and federal government funded insurances.
- Must be detail oriented with a high level of verbal and written communication skills.
- Must have high level of problem solving and presentation skills.
- Must be able to work independently, effectively supervise staff and actively participate as an integrated team member.
About Us:
Cook Children's Health Care System
Cook Children's Health Care System offers a unique approach to caring for children because we are one of the country's leading integrated pediatric health care delivery organizations. Patients benefit from the integrated system because it allows Cook Children's to use all of its resources to treat a patient and allows for easy communication between the various companies by physicians with a focus on caring for children and adolescents.
Cook Children's is an equal opportunity employer. As such, Cook Children's offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.
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Perks and Benefits
Health and Wellness
- Health Insurance
- Health Reimbursement Account
- Dental Insurance
- Vision Insurance
- Life Insurance
- Short-Term Disability
- Long-Term Disability
- FSA
- FSA With Employer Contribution
- HSA
- HSA With Employer Contribution
- Fitness Subsidies
- On-Site Gym
- Pet Insurance
- Mental Health Benefits
Parental Benefits
- Birth Parent or Maternity Leave
- Adoption Assistance Program
- Family Support Resources
- On-site/Nearby Childcare
- Adoption Leave
- Fertility Benefits
- Non-Birth Parent or Paternity Leave
Work Flexibility
- Hybrid Work Opportunities
Office Life and Perks
- Company Outings
- On-Site Cafeteria
- Holiday Events
Vacation and Time Off
- Paid Vacation
- Paid Holidays
- Personal/Sick Days
- Leave of Absence
Financial and Retirement
- Performance Bonus
- Relocation Assistance
- Financial Counseling
- 401(K) With Company Matching
Professional Development
- Tuition Reimbursement
- Promote From Within
- Access to Online Courses
- Lunch and Learns
- Leadership Training Program
- Professional Coaching
Diversity and Inclusion
- Diversity, Equity, and Inclusion Program
- Employee Resource Groups (ERG)