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Director of Provider Innovations and Partnerships

Company: Blue Cross & Blue Shield of South Carolina
Location: Columbia
Posted on: May 14, 2020

Job Description:

Oversees the research and development of multiple provider payment methodologies.-- Responsible for the development of positive and collaborative relationships with the provider community (defined as hospitals, physicians, and other healthcare providers).Description-----30% Directs the provider network negotiations involving various new payment methods and structures such as fee for service vs. fee for quality outcomes, Accountable Care Organizations, physician-led organizations, and integrated delivery systems.---30% Responsible for growing and maintaining professional, positive, collaborative relationships with the provider community. Monitors and oversees how the pilot programs are progressing.---20% Works with providers in developing programs that support transparency, quality, and harm avoidance tools in order to enhance the customer's experience.---10% Responsible for the recruitment of physicians, hospitals, other healthcare providers, and integrated delivery systems to enter into new payment methods of reimbursement.---10% Maintains working knowledge of current and proposed requirements of state and federal law which could affect existing and future provider contracting.Required Education:--Bachelors degree OR,Five years of provider contracting experience.Required Work Experience:Ten plus years of progressively complex healthcare network development experience to include seven years negotiating/maintaining network contracts, five years managing staff (or five years of equivalent military experience in grade E4 or above), and five years of healthcare financing systems and pricing methodologies.Required Skills and Abilities:--Excellent verbal and written communication skills.--Excellent customer service, organizational, and presentation skills.--Excellent analytical or critical thinking skills.--Good judgment skills.--Proficiency in spelling, punctuation, and grammar skills.--Ability to handle confidential or sensitive information with discretion.--Knowledge of mathematical or statistical concepts.--Ability to use complex mathematical calculations.--Strong public relations skills and superior negotiation skills.--Thorough knowledge of Medicare private insurance, government regulations.--Thorough knowledge of healthcare financing, reimbursement, pricing methodologies.Required Software and Other Tools:Microsoft Office.Work Environment:--Typical office environment.--Frequent travel required.--Ability to handle various stress levels.

Keywords: Blue Cross & Blue Shield of South Carolina, Columbia , Director of Provider Innovations and Partnerships, Executive , Columbia, South Carolina

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