Aledade
healthcare
Director,PayerContracting(MA&Medicaid)
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“Director, Payer Contracting (MA & Medicaid) at Aledade. Skills: Payer Contracting, Medicare Advantage contracting, Medicaid contracting, Value-based care contracts, Contract negotiation. Execute Medicare Advantage and Medicaid value-based care contracts with national and regional health plans. Negotiate value-based care contracts with health plans for their Medicare Advantage and Medicaid members”
What You'll Achieve.
Achieve goals; Improve contract terms; Ensure a smooth and timely implementation of negotiated terms; Ensure compliance; Optimize payer performance; Identify new opportunities for collaboration
Industry & Context.
Prolonged periods of sitting at a desk and working on a computer
What They're Looking For.
Must Have
Bachelor's degree, 12+ years in healthcare with health plans or provider groups working on contract negotiations within value-based care, Results-oriented with the ability to exercise influence to achieve goals rather than control, Proven track record of creating, maintaining, and enhancing relationships and communicating effectively with senior management, Exceptional attention to detail in contractual language and processes, Expert sales, business development, growth professional at local and national level, Passionate about driving the shift from fee-for-service to value based care
Nice to Have
Master’s degree or other advanced degrees in management, health services research, health and/or public policy, or other relevant fields
What You'll Do.
Execute Medicare Advantage and Medicaid value-based care contracts with national and regional health plans
Negotiate value-based care contracts with health plans for their Medicare Advantage and Medicaid members
Negotiate and renegotiate MA & Medicaid value-based care contracts with prospective payer partners
Proactively engage with payer partners to set and/or improve contract terms
Collaborate with Senior Leadership to qualify and source market growth and expansion for multi-year risk arrangements
internal stakeholders to ensure a smooth and timely implementation of negotiated terms
draft contract language
and track deliverables to ensure compliance
Compile data and report updates
Develop and maintain a deep knowledge of existing MA & Medicaid contract terms and act as the internal expert for contract questions
Build and manage relationships with payers and other key stakeholders to resolve issues
and identify new opportunities for collaboration
How You'll Work.
Team & Collaboration
Collaborate with Senior Leadership to qualify and source market growth and expansion for multi-year risk arrangements; Communicate with key, internal stakeholders to ensure a smooth and timely implementation of negotiated terms; Build and manage relationships with payers and other key stakeholders
Communication Scope
Communicating effectively with senior management
Process & Methodology
Track deliverables to ensure compliance
Full Job Description
## Description The Director, Payer Contracting, MA & Medicaid on the Strategic Payer Partnerships team will execute Aledade’s Medicare Advantage and Medicaid value-based care contracts with national and regional health plans as we help primary care providers shift into value-based care. The role will be focused on negotiating value-based care contracts with health plans for their Medicare Advantage and Medicaid members. This role will report to the VP, MA & Medicaid Contracting. We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely/work from home within the US or be based from Bethesda, MD office. Primary Duties: ## Negotiation & Strategy Negotiate and renegotiate MA & Medicaid value-based care contracts with prospective payer partners Proactively engage with payer partners to set and/or improve contract terms Collaborate with Senior Leadership to qualify and source market growth and expansion for multi-year risk arrangements ## Contract Management & Reporting Communicate with key, internal stakeholders to ensure a smooth and timely implementation of negotiated terms Read, draft contract language, and track deliverables to ensure compliance and consistency; Compile data and report updates Develop and maintain a deep knowledge of existing MA & Medicaid contract terms and act as the internal expert for contract questions ## Relationship Management Build and manage relationships with payers and other key stakeholders to resolve issues, optimize performance, and identify new opportunities for collaboration. ## Minimum Qualifications Bachelor’s degree 12+ years in healthcare with health plans or provider groups working on contract negotiations within value-based care Results-oriented with the ability to exercise influence to achieve goals rather than control Proven track record of creating, maintaining, and enhancing relationships and communicating effectively with senior management Exceptional attention to
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