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Director - Payor Strategy

Wausau, WI, USA | Aspirus

  • Industry:
    Healthcare - Hospitals
  • Position Type:
  • Functions:
    Operations / Production
  • Experience:
    10-12 years
Job Description:
70 people have viewed this job

For a 4th year in a row, Aspirus has been recognized as one of the top 15 Top Health Systems in the United States by IBM Watson in their annual study identifying the top-performing health systems in the country based on overall organizational performance.

We are seeking a DIRECTOR – PAYOR STRATEGY in Wausau, Wisconsin at Oakview Professional Building. The Administrative Director of Payor Strategy provides leadership and direction on reimbursement strategies for all payor contracts executed and managed on behalf of all ANI provider members. The Administrative Director collaborates with ANI payor contracting committee to achieve revenue goals in payor contract negotiations and in accordance with strategic direction set by the ANI Board of Directors. The Administrative Director works collaboratively to develop strategies to increase or maintain market share and provides in-depth financial and market analysis.The Administrative Director also has responsibility for smooth and efficient ANI daily operations to ensure efficient services, processes, and policies are in place to meet the needs of ANI provider members as it relates to compliance with payor contract terms. The Administrative Director develops positive working relationships with all payors’ leadership, physicians, agents and other community leaders who make or influence decisions. The Administrative Director helps facilitate and develop effective network-wide communication strategies that educate, market, and promotes value, awareness and engagement. The Administrative Director will stay current on the changes in the health care environment to help direct contracting strategies for the success of the network. The Administrative Director attends ANI Board meetings as invited and serves on or chairs other committees, as needed, and serves as an ANI representative at community events/activities.

Professional Experience / Qualifications

  • Knowledge of financial practices, business development, and health care insurance law normally acquired through completion of bachelor’s degree in accounting, finance, business, or health care management.

  • Master’s degree in health care or business administration is preferred.

  • A minimum of ten years’ health care leadership, management and other relevant health care experience.

  • Superior knowledge and understanding of the managed care environment/conditions/trends, payor contracting and health insurance industry.

  • Well-developed planning, marketing, organizing and implementing business skills.

  • Demonstrates strong knowledge of healthcare reference resources for information relevant to provider operations and compliance: CMS, CPT, HCPCS, CCI, payor and other references, manuals, etc. 

  • Possesses a comprehensive knowledge and understanding of the managed care environment/conditions/trends, value-based payor contracts, payor operations, health insurance industry, provider networks and associated legal issues.

Hours: Full time, Day Shift, Full Benefits Package

Aspirus Wausau Hospital is the flagship of the Aspirus system that serves patients in 14 counties across northern and central Wisconsin, as well as the Upper Peninsula of Michigan. It is a licensed private/not-for-profit facility with 325 beds and staffed by 350 physicians in 35 specialties.Aspirus Wausau Hospital is a Level II trauma center that provides primary, secondary and tertiary care services as a regional referral center. Specialty referral service emphasis exists in cardiology and cardiothoracic surgery, orthopedics and cancer. The hospital has an average daily inpatient census of 160 with approximately 15,000 admissions per year. Outpatient visits exceed 50,000 and there are also more than 24,000 annual emergency department visits.

Best known for its world-class cardiovascular program, Aspirus Wausau Hospital also provides leading edge cancer, trauma, women’s health, and spine and neurological care.

As an Aspirus team, we demonstrate caring, we plan to impact the future, work with happiness and enthusiasm, recognize our power to make a difference and improve the health of our communities.

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