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Senior Director, Provider Contracting - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)

Denver Health and Hospital Authority
Denver, Colorado

$143,800 - $237,400 / year

We are recruiting for a mission-driven Senior Director, Provider Contracting - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement) to join our team! We'r...

Posted 1 week ago

Crossroads Treatment Centers logo

Medical Receptionist - Duffield, VA

Crossroads Treatment Centers
Duffield, Virginia
Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Since 2005, Crossroa...

Posted 1 week ago

CenterWell logo

Medical Assistant

CenterWell
Lutz, Florida

$43,000 - $56,200 / year

Become a part of our caring community The Medical Assistant is the first contact for patient care. Responsible for administrative tasks in addition to patient care. The Medical Ass...

Posted 1 week ago

Great Plains Health logo

Registered Nurse - Medical Surgical

Great Plains Health
North Platte, Nebraska
Great people. Great careers.Join the team at Great Plains Health, where you can be a part of something, well, great. Job Title: Registered Nurse Cost Center: Medical-Surgical Job D...

Posted 1 week ago

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Emergency Medical Technician - Basic

Premier Medical Transportation
San Bernardino, California

$18+ / hour

Description We are currently hiring qualified EMTs. Both full-time and part-time positions are available. If you have the experience, and a desire to learn and succeed, send us you...

Posted 1 week ago

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Paramedic - Medical Transport - Full Time Nights

Northeast Georgia Medical Center
Gainesville, Georgia
Job Category: Allied Health Work Shift/Schedule: 12 Hr Evening - Morning Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. About...

Posted 1 week ago

Cytokinetics logo

Associate Director, Medical Science Liaison (MSL) - Central & Southern Florida, Puerto Rico

Cytokinetics
Tampa, Florida

$212,400 - $247,800 / year

Cytokinetics is a specialty cardiovascular biopharmaceutical company, building on its over 25 years of pioneering scientific innovations in muscle biology, and advancing a pipeline...

Posted 1 week ago

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Medical Assistant - Front/Back Swing, Primary Care, (Novato), Full-Time, Days

MarinHealth Medical Center
Novato, California

$28 - $31 / hour

ABOUT MARINHEALTH Are you looking for a place where you are empowered to bring innovation to reality? Join MarinHealth, an integrated, independent healthcare system with deep roots...

Posted 1 week ago

Mass General Brigham logo

Medical Assistant II- Danvers

Mass General Brigham
Danvers, Massachusetts

$23 - $25 / hour

Site: The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and syst...

Posted 1 week ago

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Medical Assistant I

University Physician Group
Detroit, Michigan
About Us: Serving one million patients and their families annually. Advancing medical knowledge, technologies and practices. Developing and educating the next generation of excepti...

Posted 1 week ago

Sharecare logo

ROI Medical Records Specialist

Sharecare
Atlanta, Georgia
Job Description: Sharecare is a digital healthcare company that delivers software and tech-enabled services to stakeholders across the healthcare ecosystem to help improve care qua...

Posted 1 week ago

Franciscan Alliance logo

MRI Technologist Urgent Care (PRN Days - West Lafayette Medical Center)

Franciscan Alliance
West Lafayette, Indiana
West Lafayette Medical Center915 Sagamore Parkway W West Lafayette, Indiana 47906 At Franciscan Urgent Care, our MRI Technologists work closely with patients to ensure they underst...

Posted 1 week ago

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Medical Assistant - MVMG Pediatrics

Alpine Physicians
Matthews, North Carolina

$19 - $21 / hour

Job Description: Join Our Team as a Medical Assistant at Colorado Physician Partners! Are you passionate about providing top-notch patient care and exceptional customer service? Co...

Posted 1 week ago

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Associate Director, US Medical Affairs – Autoantibody Neuroimmunology

6120-Janssen Scientific Affairs Legal Entity
Horsham, Pennsylvania
At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured,...

Posted 1 week ago

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Medical Assistant

TNUA Tennessee Urology Associates C
Powell, Tennessee
Why Join Us? At United Urology Group, our employees are at the heart of our mission and have incredible opportunities to impact our patients' lives with their urologic care. We fos...

Posted 1 week ago

United Vein & Vascular Centers logo

Senior Regional Medical Director

United Vein & Vascular Centers
Chicago, Illinois
Position Overview The Senior Regional Medical Director (SRMD) is responsible for the oversight of all Medical Staff within their region across all services lines. The SRMD will lea...

Posted 1 week ago

VCA Animal Hospitals logo

Medical Records Team Member

VCA Animal Hospitals
Ithaca, New York

$18 - $19 / hour

Client Service RepresentativeWe 're seeking a Part time Client Service Representative with veterinary hospital experience to join our team.At VCA Animal Hospitals, we take our miss...

Posted 1 week ago

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Medical Technologist (MT/MLT/MLS) - Covington - Full Time

Ochsner Clinic Foundation
Covington, Kentucky
We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every aw...

Posted 1 week ago

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Medical Assistant

Eastern CT Hematology and Oncology
Norwich, Connecticut
Why Join Us? The team at ECHO is comprised of the brightest and most dedicated professionals in oncology care. Working at ECHO provides an opportunity to deliver the highest level...

Posted 1 week ago

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LPN/Medical Assistant Clinic

Scotland Memorial Hospital
Laurinburg, North Carolina
Department: SCMG Laurinburg Urology - Urology Status: Full time Shift: 1st (United States of America) Schedule Details/Additional Information: Knwledge, Skills, AbilitiesPrevius Ex...

Posted 1 week ago

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Senior Director, Provider Contracting - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)

Denver Health and Hospital AuthorityDenver, Colorado

$143,800 - $237,400 / year

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Overview

Schedule
Full-time
Career level
Executive
Remote
Hybrid remote
Compensation
$143,800-$237,400/year
Benefits
Health Insurance
Dental Insurance
Vision Insurance

Job Description

We are recruiting for a mission-driven Senior Director, Provider Contracting - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement) to join our team!

We're with you for life’s journey. At Denver Health, purpose isn’t just something we believe in—it’s something we live every day, for life’s journey.

Our Values

Respect | Belonging | Accountability | Transparency

Department

Managed Care Administration

* Must Live in Colorado

*This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.

Job SummaryUnder the general supervision of the CFO, the Senior Director of Provider Contracting is responsible for developing and implementing new and established contracts for facility and professional agreements with providers on behalf of Denver Health Medical Plan, including new programs and services. This role will lead negotiations with providers to include payment terms based on multiple reimbursement models, including fee-for-service payment terms, valued based payments, and gain/risk sharing arrangements. The Senior Director will be accountable for negotiating contract language that aligns with all State and Federal laws/regulations and organizational policies. This position will be responsible for development of practices consistent with the mission and vision of Denver Health Medical Plan.Essential Functions:

  • Oversee organizational contract development and management activities and enforce organizational principles of integrity and compliance (15%)
  • Develop standards for contracts, including payment terms, general language and provisions based on strategy discussions, senior management input and organizational needs (15%)
  • Evaluate rate proposals, changes to reimbursement methodologies and conduct related analyses to ensure continued financial viability of the contract (10%)
  • Ensure contracts and proposals are properly entered into organizational databases to measure, track and monitor utilization and financial performance (10%)
  • Negotiate single case agreements as needed (5%)
  • Serve as primary organizational contact during provider contract negotiations (10%)
  • Identifies network needs and manages the recruitment and contracting process for new providers and institutions (5%)
  • Ensure prompt resolution of all escalated concerns or issues from the Plan’s provider network (5%)
  • Participate in JOC meetings with providers to address contractual payment issues and trends (5%)
  • Validate the proper uploading, adjudication, and pricing of claims (5%)
  • Maintain knowledge and understanding of healthcare industry trends, standards, and current events relative to provider contracting, network administration and market (5%)
  • Carry out supervisory responsibilities in accordance with the organization’s policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems (5%)
  • Special projects/ other duties as assigned by the CFO (5%)

Education:

  • Bachelor's Degree Degree Concentration in Finance, Accounting, Business, Management, Healthcare Administration related field Required

Work Experience:

  • 10+ years Contract Management demonstrated experience required; provider contracting experience preferred required
  • 4-6 years manager experience required, preferably in healthcare required

Licenses:Knowledge, Skills and Abilities:

  • Strong knowledge of Medicaid, Commercial ACA, Medicare, and CHP+ lines of business is required
  • Knowledge of CPT, ICD-9 and 10, DRG, HCPCS, RBRVS, bundled payments, risk-sharing, and provider capitation is essential
  • Extensive knowledge and experience with Medicare/Medicaid regulations
  • Excellent negotiating skills and proficiency in utilizing and interpreting financial models and analysis
  • Requires high attention to detail, analytical and critical thinking, management skills, organization, prioritization and problem resolution
  • Excellent verbal and written communication, leadership, delegation, collaboration and interpersonal skills
  • Ability to be resourceful, customer-service oriented and independently problem solve is required

* Must Live in Colorado

*This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.

Shift

Days (United States of America)

Work Type

Regular

Salary

$143,800.00 - $237,400.00 / yr

Benefits

At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future — with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development — while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you’re joining a mission-driven organization that invests in you.

Here is a small list of our benefit programs:

  • Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays

  • 100% paid parental leave up to 6 weeks

  • Immediate eligibility for retirement plans with employer contribution up to 9.5%

  • Generous medical, dental, vision plans in addition to employer paid disability and life insurance.

  • Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center

  • Free RTD EcoPass (public transportation)

  • Childcare discount programs & exclusive perks on large brands, travel, and more

  • Tuition reimbursement & assistance

  • Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways

  • Professional clinical advancement program & shared governance

  • Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program

  • National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

About Denver Health

Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation.

As Colorado’s primary, and essential, safety-net health care system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year.

Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled.

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