Why Work With Us – Tal Healthcare

Director, Risk Contracting & Management

New York Metro Area NY

Posted: 12/07/2018 Department: Healthcare Finance and Operations Job Number: 5168

Title: Director, Risk Contracting & Management

Location: New York Metro Area, NY

Industry: Healthcare

Occupational Category: Administrative/Operations

Hours: Full-time

Description: Hiring a Director, Risk Contracting & Management for a managed care organization located in the New York City area.

Responsibilities:

  • Develop relationships with Senior Executives and leadership.
  • Assist VP in renegotiation of all financial and contractual terms during renewal. Develop financial proposals for renewal including supporting documentation and analyses.
  • Document requested revisions to contractual terms and rationale for requested revisions.
  • Develop and manage new forum for key providers and partners to share best practices on effectively facilitating costs.
  • Collaborate with medical management team to develop forum, solicit participation, and set an agenda.
  • Manage the team that provides service support for all value-based arrangements, including the research and resolution of claims payment and utilization management issues, provider appeals, etc.
  • Determine Root causes to properly implement corrective actions to resolve these issues.
  • Monitor financial and utilization performance.
  • Analyze performance against internal and external benchmarks.
  • Identify opportunities for improvement.
  • Implement new Governance structure
  • Actively participate in all levels of Governance Committees.
  • Develop and maintain reporting packages.
  • Responsible for overseeing the creation and ongoing monitoring of performance dashboards for value-based groups.

Education Requirements:

  • BA/BS Required
  • Master’s Degree (MBA, MPH) preferred

Experience Requirements:

  • 8-10 years relevant experience in provider contracting, network management, medical management, or other relevant health plan provider or government experience.

Lea Tal

CEO
43 Kensico Dr, Mt. Kisco NY 10549 USA

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