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Job Description

The Director, Hospital Contract Support (DHCS), will be responsible for the management and development of the analyses of MSHS?s performance under managed care ancillary, hospital and facility contract arrangements. The DHCS will establish the policies, procedures, and business processes to ensure oversight of MSHS hospital and facility contract performance and will lead the analysis process in support of potential contracts which MSHS may enter. The DHCS will ensure payers are reimbursed in line with their contracts, and drive audit and recovery processes in partnership with Patient Accounts as appropriate. The DHCS will report to the Senior Director Hospital Contract and Analytics. The Director ensures optimal results are achieved with high employee engagement, while adhering to institutional policies and any applicable regulatory requirements.

Qualifications

Education & Experience

• Bachelor's Degree required, MBA or advanced business degree in related finance or health care discipline preferred.

• Minimum 5-7 years' experience in managed care contracting, hospital reimbursement, billing, and/or contracting.

Additional Skills

• Advanced abilities in Microsoft Office Suite (Word/Excel/PowerPoint).

• Clearly conveys information, data and concepts in a manner which engages the audience and helps them understand and retain the message.

• Identifies and understands issues, challenges and opportunities; develops effective courses of action or appropriate solutions and follow through to ensure closure. Takes action consistent with available facts, constraints, and probable consequences.

• Builds a successful team using appropriate methods and a flexible interpersonal style to create a cohesive team focused on meeting goals and objectives.

• Maintains effectiveness when experiencing opposition, working under pressure or during major changes in work responsibilities or environment; adjusts effectively to work within new work structures, processes, requirements, or cultures.

• Interacts with others to build trust and provide confidence in one?s intentions and those of the organization.

• Sets high goals for personal and group accomplishments using measurable methods to monitor progress, tenaciously working to meet or exceed goals. Provides feedback, instruction, and development guidance to help others excel in their current or future job responsibilities

Non-Bargaining Unit, E01 - Partner MSO Services - MSH, Mount Sinai Hospital

Responsibilities

• Responsible for the development, implementation, standardization and use of reporting tools to monitor MSHS and Payer compliance with hospital and facility managed care and population health management contract arrangements. These tools include the Microsoft Office programs, Concuity, Experian, EPSI, Crimson and other electronic tools.

• Maintains the business intelligence reporting frameworks, tools, and data marts while working cross-functionally with various MSHS department leaders to ensure high-quality hospital and facility contract reporting and analytics.

• Develops and coordinates analyses o f hospital and facility contracts and the operational impact of various contracts. Drives resultant or other audits and recovery projects to ensure receipt of billed revenue through settlements or rate revisions.

• Supports the negotiation of hospital and facility contracts and implementation of these agreements.

• Oversees, coordinates and supports Joint Operation Committee (JOC) meetings with the Payer.

• Project manages, coordinates and tracks contractual issue resolution.

• Collaborates with the Information Technology and other departments to implement electronic tools to track, monitor, and evaluate MSHS hospital and facility contract performance.

• Prepares and/or coordinates financial and utilization analyses to develop and evaluate compensation methodologies and rate proposals, under payment, denial and retro rate recoveries and adjustments.

• Delivers regular reports to executive leadership on the performance of MSHS hospital and facility network related to quality, efficiency, and process measures.

• Leads strategic discussions with market leadership teams, senior management, and others, resulting in development and successful execution of coordinated institutional contracting plans based on data analysis and reporting trends.

• Manages operations within assigned department or division; uses data and fact-based problem solving techniques to improve processes and outcomes. Ensures that all operations run according to institutional and departmental policies and in accordance with any government or regulatory requirements as applicable.

• Assists in the planning, development, and/or maintains departmental standard operating procedures. Regularly reviews policies and procedures and makes recommendations for changes to superiors as necessary.

• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state of-the-art practices; participating in professional societies.

• Provide leadership for in the form of ongoing training, goal setting, and problem resolution to cultivate a culture of innovation and creativity in service of better patient care.

• Performs all other duties as assigned.

Collaboration and Leadership

• Collaborates with other business units to understand strategic goals and promote an environment conducive to creativity, change and information exchange.

• Assists in the training, coaching, mentoring of staff in accordance with all internal policies and procedures. Communicates values, strategies, and objectives of department or division on a regular basis. Assigns accountabilities, delegate's tasks and responsibilities as appropriate.

About Us

Strength Through Diversity

The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by:

• Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential.

• Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination.

• Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers.

At Mount Sinai, our leaders strive to learn, empower others, and embrace change to further advance equity and improve the well-being of staff, patients, and the organization. We expect our leaders to embrace anti-racism, create a collaborative and respectful environment, and constructively disrupt the status quo to improve the system and enhance care for our patients. We work hard to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to advance professionally.

Explore more about this opportunity and how you can help us write a new chapter in our history!

“About the Mount Sinai Health System:

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism.”

EOE Minorities/Women/Disabled/Veterans

Compensation Statement

Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $140000 - $261661.2 Annually. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.