Director of Payor Strategies
Mental Health Center of Denver

Job Info

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EMPLOYMENT VALUE PROPOSITION: Mental Health Center of Denver provides you with the support you need to help you develop a career in helping others succeed. We innovate, adapt, and leverage the diverse perspectives of the people on our team and the people we serve in everything we do.

COMMITMENT TO DIVERSITY & INCLUSIVENESS: The Mental Health Center of Denver values and is strengthened by diversity. We are committed to ending bias and discrimination in our community and ensuring equity within all aspects of our organization. We are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment, transfer, or promotion opportunities without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

COMMITMENT TO PAY EQUITY: Mental Health Center of Denver is committed to fair and equitable hiring with salaries based on relevant factors, such as work experience, education, and certification/licensure (rather than wage history). Toward the principle of equal pay for equal work, we post and hire within defined hiring salary ranges. We ask all applicants to carefully review the hiring salary range for each posted job opportunity, as we will not hire outside the predetermined range.

BENEFITS STATEMENT: All full-time, benefits eligible employees will be eligible for MHCD's benefits plan. For a full description of benefit offerings, please visit: https://mhcd.org/workplace-of-choice/.

COVID VACCINATION NOTICE: Under the COVID-19 mandate issued by the Denver Department of Public Health and Environment on August 2, 2021, current MHCD personnel must be fully vaccinated, or be approved for exemption, no later than September 30, 2021. "Fully vaccinated" means two weeks (14 days) after receiving the final dose of vaccine. The "final dose" is the second dose of a two-dose vaccine (Pfizer or Moderna) or the single dose of a one dose vaccine (J&J).

Learn what it is like to work at the Mental Health Center of Denver:

STARTING SALARY: $97,600/yr - $125,000/yr

POSITION SUMMARY: Plan, direct, and coordinate the payer policies, goals, and objectives related to contract language and rate pricing, negotiation strategy, planning and execution, revenue reconciliation, and payer relationship management. This position provides strategic leadership, financial and administrative oversight of payer contracting on behalf of the organization to support payer strategy formation and negotiation. This position works closely with executive management, clinical departments, operations departments, finance department, and revenue cycle management and, provides leadership to contract support and credentialing.

ESSENTIAL JOB FUNCTIONS:

• Develop and manage a portfolio of payer contracts that optimize organization revenue, margin and growth in alignment with organizational mission and strategic objectives.
• Establish and maintain positive, appropriate relationships with market payers. Utilize communication and organizational skills to work collaboratively and credibly with payers to achieve common objectives.
• Work collaboratively with internal stakeholders to define and achieve common payer strategy and reimbursement objectives.
• Develop and execute communication plans to internal and external stakeholders related to contract performance, payer relationships, negotiations, organizational contractual obligations, and developments in the managed care marketplace.
• Coordinate financial analysis of payer contract performance and modeling projections based on alternate contract agreements with payers, adverse trends, etc., and make appropriate recommendations or conclusions.
• Analyze and monitor financial aspects of existing managed care contracts. Utilize analysis for feedback on contract renewals, renegotiations, or termination. Make recommendations regarding participation or non-participation with new or existing agreements. Provide feedback to Vice President and Chief Financial Officer regarding financial and/or operational issues with payers.
• Manage the new business vetting and implementation meetings. Work with internal stakeholders to ensure key information is presented to support go or no go decisions and effective implementation of new programs.
• Responsible for interviewing and hiring staff members, as well as performing any disciplinary actions including termination.
• Create and maintain relationships within the organization as well as foster partnerships in the community.
• Commitment to participation in ongoing cultural proficiency work and active support of the organization's diversity, equity and inclusiveness efforts.
• Maintain a trauma informed environment of wellbeing.
• Other duties as assigned.

EDUCATION: Bachelor's Degree in Business, Accounting, Finance, Healthcare Administration or related discipline. In lieu of a Bachelor's degree, will consider candidates with 15+ years of experience as listed below.

EXPERIENCE: Mental Health/Health Care experience with a minimum of ten years of contract negotiation, rate setting, and working within a Medicaid, Medicare and Managed Care environment. Significant knowledge of contractual, administrative, health insurance and operational issues related to managed care organizations, physician groups, and health insurance benefit plan designs. Proven and extensive contracting technical skills; negotiation skills, contract preparation and implementation, financial analysis and rate proposal development, and in depth knowledge of various reimbursement methodologies.

SKILLS AND COMPETENCIES:

• Excellent written, verbal and interpersonal skills with the ability to effectively interface with senior management and staff.
• Strong negotiation skills and the ability to provide cost analyses and set rates and market services.
• Ability to manage multiple priorities in an efficient, accurate and timely fashion.
• Ability to influence valuable change and positive outcomes with both direct and indirect reports and peers.
• High degree of critical thinking, excellent judgement and problem-solving skills.
• Strong data analytical skills measuring process and outcomes in healthcare.
• Strong skills presenting complex data and outcomes to executive teams.
• Ability to build trust and camaraderie between team members.
• Knowledge or ability to learn and practice trauma informed principles and practices.
• Experience working directly with people from diverse racial, ethnic, and socioeconomic backgrounds.
• Strong computer and customer service skills.
• Competence in Microsoft Excel spreadsheet application.
• Ability to communicate effectively and work cooperatively with internal and external customers.
• Valid Colorado Driver License in good standing. Clean driving record.

SUPERVISORY RESPONSIBILITIES: Contract

MACHINES AND EQUIPMENT TO BE USED: Computers, calculators, fax machines, copiers, telephone and a variety of other office/clerical equipment.

TYPICAL PHYSICAL DEMANDS: Requires sitting, standing, bending and reaching. Requires manual dexterity sufficient to operate standard office machines such as computers, fax machines, the telephone and other office and/or clinical equipment.

WORKING CONDITIONS: May require occasional evening or weekend hours.

This job has expired.