Director of Health Plan Contracting, Olympia, WA

The Washington Rural Health Collaborative (The Collaborative) is seeking an experienced leader who is responsible for developing strategies and managing negotiations for payer contracts on behalf of The Rural Collaborative and its Members. This position will work in a hybrid remote and corporate office setting.

TO APPLY

To find out more about us and apply, please go to https://ruralcollaborative.com/contact-us/. First consideration given to applications received by 4/7/23. Position open until filled.

OUR MISSION

We defend, create and design the future of rural health care through collective strategy and action.

OUR ORGANIZATION

The Washington Rural Health Collaborative (the Collaborative) is a mature and robust network of 21 Rural Critical Access Hospitals, all separately governed and predominantly serving areas along the coastal corridor of Western Washington. The Collaborative’s work is a dynamic interaction involving teamwork, forming alliances, and building relationships through cooperation in a fast-paced, flexible environment. The Collaborative, founded in 2003, enjoys stable leadership, a well-defined mission, and a formalized organizational structure with a demonstrated history of delivering value to members and the rural communities they serve. Our strength is collectively creating synergy among to achieve more than individual members can achieve separately.

SALARY & BENEFITS

Competitive salary based on experience.

WHRC provides a great benefits package including:

• Health, Dental & Vision Insurance
• HSA monthly contribution for eligible employees
• Generous Paid Time Off (PTO) program
• 9 Paid Holidays
• 401(k) Retirement with up to 3% company match
• Social Security, Unemployment Insurance, and Industrial Insurance.

JOB SUMMARY

The Director of Health Plan Contracting & Payer Relations (Director) is responsible for developing strategies and managing negotiations for payer contracts on behalf of the Washington Rural Health Collaborative d/b/a The Rural Collaborative (TRC), and its Members. The Director is responsible for identifying and managing contracts associated with national and regional payers, including but not limited to Washington’s Medicaid Managed Care Organizations (MCOs) and the commercial payer communities. This includes managing product development, contract execution, and revenue generated for commercial, Medicare Advantage, Medicaid, and Accountable Care or Value-Based initiatives.

The position is responsible for negotiating the various specific contract terms within each payer contract, including but not limited to, traditional fee-for-service arrangements, attributed life risk arrangements, quality bonuses and shared or full risk terms for accountable lives. The position is also responsible for developing and maintaining strong relationships between the payers and TRC membership. Additionally, the Director has direct responsibility to provide executive support to TRC’s Revenue Integrity Committee (RIC) and is responsible for developing and advancing TRC’s payer-related strategic initiatives.

The ideal candidate will have extensive experience in developing and negotiating contractual terms and conditions for health plan contracts with health systems. The incumbent should have experience in understanding the key components of contract structure and will be able to identify and negotiate mutually agreeable terms, conditions, language of complex contract offerings and value-based agreements. Additionally, the Director should have a working knowledge of cost-based reimbursement methodologies for Critical Access Hospitals.

QUALIFICATIONS

Education and Experience:

• Five or more years relevant experience in healthcare or related field, including three-or more years of prior experience in health plan contract negotiation and management, in areas such as value-based arrangements, Medicaid Managed Care agreements, and RFP development.
• Experience working on a management team in healthcare or a related field.
• Bachelor’s degree in business, healthcare management or related field required. Master’s degree in healthcare management preferred.
• Experience with government programs and Medicare Advantage preferred.
• Experience working within a health plan or rural health system preferred.

Some Other Requirements:

• Washington resident with valid driver’s license and proof of insurance required by time of hire.
• Incumbent will be subject to background and professional reference checks.
• Most of the work is performed remotely and in Olympia office. There is an expectation of being in the Olympia office at least four times per year at employee’s expense.

For full job description and qualifications, please visit https://ruralcollaborative.com/contact-us/

The Collaborative is an Equal Opportunity Employer