Director Provider Contracting at One Call Medical, Inc. in Dover, Delaware

Job Description:

Director Provider Contracting



Are you looking for an impactful role where you finish the workday knowing you helped someone? Whether you're joining our care coordination team or playing a supporting role, the work you do every day helps us collectively reach our mission of "getting people the care they need when they need it." We believe that by staying committed to our core values of Think Big, Go Fast, Deliver Awe,and Win Together, we can positively impact the lives of the injured workers we serve and get them back to the things that matter most in life.



Salary Range: $86000 - $141800 Salary


This compensation range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At One Call, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $86000 - $141800 Salary



Benefits Summary:

In return for your commitment to our company's mission, we offer a vast array of benefits to help support the whole you.


• Opportunities to work from home


• Competitive wages with opportunities to earn annual merit increases


• Paid development hours to use for professional and community development!


• 18 days of Paid Time plus 8 company holidays, and 2 personal days per year


• $1,000 Colleague Referral Program


• Enterprise Recognition Program rewarding colleagues for their extraordinary work


• Exclusive discounts on travel, activities, and merchandise via work discount program


• Colleague Assistance Program that provides free counseling and financial services


• Tuition Reimbursement Program including certifications


• Quantum Health: A healthcare navigation platform to help our colleagues make the best, most cost-effective healthcare decisions


• Medical, dental, and vision insurance


• Pre-Tax FSA and HSA health savings accounts


• 401(k) matching


• Company paid life insurance


• Company paid short term and long-term disability


• Healthcare concierge


• Pet Insurance


• The One Call Foundation which aims to help colleagues during unexpected emergencies, from car accidents to natural disasters.




JOB SUMMARY:



Leadership role accountable for the execution of contracting commitments and priorities, leading the assessment, evaluation, and design of strategy for initiatives, approaches and/or solutions related to provider contracting and network margin optimization. Requires the ability to recruit the correct resources, motivate, retain, develop, and lead a team of professionals to achieve targeted results. Critical thinker with strong project management, time management, and organizational skills who can coordinate the input and interests of internal teams, driving efforts associated with provider contracting to execution under tight time frames. Has considerable latitude for independent judgment and should be comfortable and practiced in making managerial decisions, leading strategy, and engaging executive leadership appropriately when necessary.




GENERAL DUTIES & RESPONSIBILITIES:



Think Big: - Strategic Acumen 40%



§ Oversee the development and implementation of strategic initiatives and contracting activities.


§ Proven analytical and critical thinking skills with the ability to develop, implement, and monitor business solutions in support of network design and margin optimization.


§ Adept at designing and building solutions through research and analysis of data and business process, conducting, or coordinating analytic activities (analyses and report creation) in support of projects and initiatives across multiple products.


§ Champions strategies for the development, implementation, and management of contractual arrangements that support favorable unit cost performance and create forward-looking strategy.


§ Possesses formidable financial and contract acumen with proficiency in analyzing and interpreting trends in the provider contracting arena.


§ Creates and manages initiatives that improve total medical cost and quality.


Deliver Awe: - Collaboration 30%



§ Lead and actively participate in strategic planning initiatives with business partners across the organization to develop, drive and execute on strategies.


§ Ability to define a problem statement, form hypotheses, and request appropriate analysis to support the decision-making process and work with appropriate subject matter experts to resolve.


§ Ability to work collaboratively with internal and external constituents to gain consensus / support and manage stakeholder alignment and approval.


WIN Together: Team Management 30%



§ Direct the evaluation, review, negotiations and ongoing management of contracts and amendments between One Call and Providers


§ Determine necessary resources to develop the network and assemble the appropriate team.


§ Manage performance target setting and performance reporting.


§ Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management.


§ Directs the evaluation, review, negotiations, and ongoing management of contracts and amendments.


§ Monitors performance, develops, and implements business solutions to address process and network quality gaps.



EDUCATIONAL AND EXPERIENCE REQUIREMENTS:



§ Bachelor's degree (B.A. or B.S.) and 8 years of experience or the equivalent combination of education, training, or work experience



GENERAL KNOWLEDGE, SKILLS & ABILITIES:



§ Expert knowledge of the workers compensation industry


§ Excellent verbal and written communication skills to technical and non-technical audiences of various levels within the organization (e.g., executive, management, individual contributors)


§ Excellent problem solving, time management, and work prioritization skills.


§ Ability to manage multiple deadlines for self and others.


§ Requires proficient negotiation skills and tactics, both written and verbal


§ Ability to establish and maintain relationships with internal and external customers.


§ Comfortable with change and possesses the ability to switch tasks and priorities seamlessly.


§ Experience utilizing financial models and analyses in negotiating network rates.


§ Ability to operate MS Office suite effectively: Word, Excel, PowerPoint, Outlook, Teams etc.



PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENT:



§ The job can be emotionally demanding due to various factors such as a heavy workload, dealing with sensitive information, and specific responsibilities within the team.


§ This job primarily operates office equipment and involves repetitive motions.


§ The colleague must regularly use hands and fingers, speak, concentrate for extended periods of time, and hear.


§ Specific vision abilities to observe details at close range and ability to adjust focus.


§ The colleague must be able to remain in a stationary position at least 75% of the time and may be required to lift objects (up to 10lbs weight; up to 4 ft. height)


§ Please be advised this job description is subject to change at any time.