Payor Contracting Business Partner - FT
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
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Facility: Sanford Business Center Building
Location: Sioux Falls, SD
Address: 2200 E Benson Rd, Sioux Falls, SD 57104, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
This individual will be a liaison between internal and external stakeholders and are in charge of escalated issues as well as building and maintaining strong relationships. This position does sit at the Sanford Business Center. After training is complete and productivity standards are met, there is potential to work from home up to two days per week.
Provides guidance for payor contracting strategy and implementation. Oversees assigned payor relationships for the enterprise, and analytics to support and ensure long-term financial success for all entities, under various and changing payment methodologies and incentives.
• Debates issues to bring the most critical points to the forefront for decision
• Evaluates alternative conflict resolution strategies in context of organization's
• Establishes and maintains effective working relationship with each team member.
• Adapts standard communication approaches when conducting dialogue with different audiences or conveying messages.
• Handles complex situations in which there are a great number of cues and/or
stakeholder interests to be taken into account.
• Supports partners' business objectives to help the partnership thrive. Responsible for day-to-day administrative activities and maintaining relations with payors, acting as a liaison to handle escalated issues. Frequent negotiation of rates with payors. Knowledgeable of current/future payment methodologies and underlying financial incentives. Connects with operations to ensure leadership
remains abreast of important trends and changes. Develops and maintains executive level relationships with major payors across the enterprise. Engages enterprise leadership to ensure the maximization of reimbursement through commercial payor contracts. Assists in strategy development for risk based contracting and shared savings arrangements; including coordination with enterprise population health efforts, quality initiatives, and direct to employer sales efforts. Maintains latest knowledge of industry trends in contracting, payment methodologies, and payor relationships. Assists with the development and
implementation of a comprehensive contract and payment analytics function, including the development of staff competencies in risk based contract analytics. Supports organizational efforts to influence state and federal laws and regulation, particularly focused on payment initiatives.
Bachelor's degree in finance, healthcare administration, business or other related field required. In lieu of education, leadership may consider 5 years of applicable experience.
The ideal candidate has three years or more experience in payor or healthcare provider contracting.
Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, sick leave and paid time off. To review your benefit eligibility, visit https://sanfordhealth.jobs/benefits .
Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to firstname.lastname@example.org .
Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.
Job Function: Legal and Compliance
Req Number: R-63566