Director, Payor Relations

Location: Calmont Operations Building Department: Payor Relations Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: The Director of Payor Relations is responsible for developing and maintaining meaningful and effective relationships with managed care organizations and internal staff with the goal of securing, managing, and renegotiating viable, revenue generating health care service contracts on behalf of CCHCS entities and providers with both commercial and government funded managed care organizations. The Director will manage payor intelligence, contract implementation and validation as well as oversee issues and follow up on contract related claims issues. Qualifications: Bachelor's degree preferred. At least ten (10) years of operational experience in a manage care setting required. Extensive experience in contract negotiation and payor relations required. Superior knowledge of medical terminology. Must be able to foster and maintain healthy relationships with outside payors. Must have a clear understanding of the intricacies of commercial, state and federal government funded insurances. Must be detail oriented with a high level of verbal and written communication skills. Must have high level of problem solving and presentation skills. Must be able to work independently, effectively supervise staff and actively participate as an integrated team member. About Us: Cook Children's Health Care System Cook Children's Health Care System offers a unique approach to caring for children because we are one of the country's leading integrated pediatric health care delivery organizations. Patients benefit from the integrated system because it allows Cook Children's to use all of its resources to treat a patient and allows for easy communication between the various companies by physicians with a focus on caring for children and adolescents. As such, Cook Children's offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination. Promise, a strong word with deep meaning that everyone understands—especially kids. This is the foundation of our organization and what drives us to blaze new trails in medical care, research, advanced technology, as well as programs and initiatives that benefit children who may not otherwise have access to quality health care. Every day our employees come to work with the intention of keeping our Promise. It's the guiding principle that helps our patients and their families get better and stay healthy. As a member of our Cook Children's team, you can be an important part of making that happen. Please, create a profile and upload your resume/CV by clicking the Get Started button.