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MMM Holdings

Job Description

POSITION TITLE: Director of Contracting

DEPARTMENT: Clinical Staff Solutions

POSITION DESCRIPTION

This position requires an active director who will provide leadership and strategic vision towards continuous improvement and who will participate in all aspects of service delivery. Have responsibilities for: strategic planning, contracting providers, developing value base compensation models, oversight capitation process, integrity and efficiency of departmental processes. Monitor physicians’, specialists, non-IPAs’ PCPs and/or IPAs’ satisfaction, as well as operational competence and compliance with contract requirements and utilizations’ goals. This position is under the direct supervision of AVP Clinical Staff Solutions to facilitate the communication process and increase knowledge between Clinical Staff Solutions, MMM Multiclinics and/or any other affiliated clinic or practice for whom Clinical Staff Solutions providers services. This position is also responsible for the management of the internal operational and external operation of the Clinical Staff Solutions. Monitors operations of contracts, analyze reports, planning and contracting projections.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Plans, directs and implements the contracting strategy and provider education process consistent with the mission, vision and network development strategy of Clinical Staff Solutions. Assumes daily operational management of all departmental staffing and activities related to contracting strategies and operation also is responsible of daily report of the operation. Assist in negotiations and contracting process of the Clinical Staff Solution. Interviews, hires, evaluate, counsels and terminate employees and contractors. Identifies opportunities for improvement and provides additional orientation and skill development on an ongoing basis. Develops provider communications (i.e. letters, contracts, reference materials etc.) Identifies, analyzes, plan, organizes and develops new workflow processes and/or modifies the existing ones to meet contracting and provider education requirements. Develops in conjunction with the AVP of Clinical Staff Solutions the operational budget for the department. Maintains staffing levels according to provider network and designated departmental functions. Maintains and updates policy and procedures for the Contracting of Clinical Staff Solutions. With Medical and Contracting leadership, joint responsibilities for negotiating contract directly with physicians and other strategic partners. Accountable for reporting any contracting outcomes. Maintains open communication with internal and external customers. Maintains regularly scheduled meetings with the regional supervision personnel including 1:1 scheduled, individual meetings. Participates in internal Quality Committee, Contracting Committee, and any work related activities as directed by the Clinical Management. Develop corrective action plans as necessary in response to audit results. Assures that the Department operates within budgetary constraints approved through appropriate organizational structure. Assist as a resource to the internal and external customer. Represent the company in special activities related to provider network and other public relations. Oversees the contracting effort for the Clinical Staff Solutions. Responsible to submit to the AVP of CSS all provider prospects with region needs analysis. Assist in difficult contracting, negotiations and orientations. Ensure there are regular documented meetings for all key staff to discuss and plan objectives and work/activity plans. Responsible to make frequent ride alone with Regional Supervisor and make an evaluation of this ride in order to improve conversation and other field techniques and performance. Responsible to assure that all Clinical Staff Solutions Network will be fully oriented regarding all MMM-Multichines and afiiliatesplans processes. Work and analyze different electronic reports in order to identify and work with provider needs. Responsible to discuss and analyze weekly reports and develop strategies to meet the Department goals. Works in conjunction with AVP of CSS and Finance Director to monitor, develop, and adjust provider compensation models, value base metrics, monitoring KPI’s and corrective actions plans when needed. Performs any other special job-related duties as assigned by the VP of Contracting & Provider Relations.

EDUCATION AND EXPERIENCE

Minimum Requirements:

LANGUAGE SKILLS

Ability to write reports, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

MATHEMATICAL SKILLS

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

REASONING ABILITY

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

INTERPERSONAL RELATIONS

The responsibility of this position requires interaction with the Chief Operating Officer and the Executive Management Team to report findings and/or clear any doubts.

GENERAL SKILLS

Effective supervision, interpersonal communication and customer service skills: practicing, valuing and supporting service to both internal and external customers. Ability to operate various types of office equipment including software packages such as Office – Word, Excel and Power Point - 2000 and Outlook – and database familiarity a plus. Self-directed with good organizational skills. Fully Bilingual (English – Spanish) Manage and solve problems and train employees. Time management skills; establishing priorities and accomplishing tasks in an accurate and timely basis. Project Management skills

PHYSICAL AND MENTAL DEMANDS

While working, the employee is driving, sitting, walking, talking, and listening most of the time. Performed tasks require independent knowledge and judgment in addition to provided instructions and procedures. Must be able to function with frequent interruptions, accept change and able to prioritize activities when faced with competing demands.

ENVIRONMENTAL AND WORKING CONDITIONS

Irregular office environment. Willing to travel around the island. Moderate noise (examples: business office with computers and printers, light traffic)

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!