Opportunity

McLaren Physician Partners (MPP), a subsidiary of $7B McLaren Health Care, is searching for a visionary and results-oriented leader to serve as its next Director of Payor Contracting.

Overseeing third-party payor contracting across all market segments for MPP, McLaren Health Care, and its subsidiaries across Michigan, the Director will shape strategy, drive performance, and partner closely with the Vice President of Payor Contracting on contract outcomes and risk management.

Position Summary

• Responsible for managing contracting activities with third-party payors.
• Collaborates on strategic planning for contracting activities.
• Resource for all contracting activities of MPP, McLaren Health Care Corporation and its subsidiaries. This includes, but not limited to review, redline, and evaluation of language of the Managed Care contracts.
• Participates in and leads negotiations, identifies any issues and coordinates contract workflow/approval through to contract execution.
• Leads and coordinates maintenance, development and upkeep of contracting database along with reporting of dashboard metrics to Vice President.
• Develops and implements policies and processes to monitor contractual obligations and ensure MPP and McLaren’s compliance with such (i.e., annual performance benchmarks, payment rate changes, etc.).
• Analyzes changes in legislation, payor policies, rules and regulations impacting both facility and physician payments. Communicates and educates those impacted, as necessary.
• Acts as liaison between contracted Health Plans and MPP, McLaren, McLaren High Performance Network, and other subsidiaries, including but not limited to, research operational issues and develop work plans needed to resolve issues.
• Identifies and communicates process improvements to the contracting process and data requirements.

Position Requirements

• Bachelor’s degree in business, health care or related field required.
• Master’s degree in Health Care Management, Finance or related field preferred.
• Minimum of five (5) years’ total experience in complex provider contracting and servicing in a health system managed care organization, Health Plan, PHO, PO or similar organization.
• Ten (10) years’ experience in provider contracting and servicing in a health system managed care organization, Health Plan, PHO, PO or similar organization preferred.
• Three (3) years in a leadership role leading a professional staff of five or more members in all phases of effective supervision (i.e., recruitment, performance management, training) required.
• Experience with standard and innovative contract and reimbursement methodologies, including but not limited to fee for service, value-based payments, risk contracting, capitation and bundled payments.
• Established relationships with health plans and other industry professionals.
• Stakeholder Influence: influential and persuasive in interacting with medical providers, medical office staff, hospital/facility medical and administrative staff, payors/health plans.
• Analytical Thinking: proficient in problem-solving and quantitative analytical skills.
• Prioritization: Ability to organize and prioritize workload.
• Communications: demonstrated excellent writing, communication, and interpersonal skills. Interacts with all internal and external customers in a positive, consistent, enthusiastic, and open-mannered approach. Exhibits skill in communicating complex information at a level of understanding for the appropriate intended recipients.
• Decision Making: uses independent judgment to exercise authority on behalf of McLaren Health Plan by keeping the organization’s mission, vision, and values at the forefront.
• Self-Directed: works independently in a self-directed, non-confrontational, collaborative manner.
• Customer Focus: promotes positive internal and external relations by actively seeking and being responsive to customer feedback. Ability to support and participate in continuous quality improvement projects.
• Planning/Organization: shows organizational skills through effective planning and delegating. Constantly seeks opportunities to improve processes to support more efficient and effective work outcomes.
• Financial Management: manages assigned departments and budget within specified parameters. Consistently contributes to sound financial practices.

Compensation

An attractive compensation, benefits, and relocation package will be offered commensurate with the candidate’s experience.