AIDS Healthcare Foundation

  • National Director of Contracting and Provider Relations

    Job Locations US-CA-Los Angeles
    Req No
    2018-8235
    Category
    Administrative/Clerical
    Type
    Regular Full-Time
  • WHO WE ARE

    AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation!

     

    Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?

     

    If so, AIDS Healthcare Foundation is the place for you!

     

    Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

      

    AHF’s core values are to be:

     

    • Patient-Centered

    • Value Employees

    • Respect for Diversity

    • Nimble

    • Fight for What’s Right

     

     

    STILL INTERESTED? Please continue!

     

     

     

    AIDS Healthcare Foundation is seeking a Full-Time,  National Director of Contracting and Provider Relations to join our Managed Care Division Leadership Team located at the following address:

     

    1001 North Martel Avenue

    Los Angeles, California 90046

     

    Hours of Operations:  Monday - Friday, 8:30am-5:30pm

    YOUR CONTRIBUTION TO OUR SUCCESS!

    The National Director Contracting and Provider Relations is integral part of AHF’s Managed Care Division’s leadership team.  He or she develops the organization’s provider recruitment and retention strategy and tactical plan in support of AHF’s California Medicare and Medi-Cal health plans and Ryan-White funded programs across the United States.

     

    The Director negotiates competitive and cost-effective contracts with hospitals, nursing facilities, home health agencies, ancillary health service providers, medical groups, independent physician associations (IPAs), and independent providers such that the networks meet enrollee/patient needs and network adequacy requirements of Centers for Medicare and Medicaid Services (CMS), California Department of Health Care Services (DHCS), and Ryan White-funded programs.   In addition to supporting the Managed Care Division’s plans and programs, the Director contracts with third party insurances to include AHF’s Healthcare Centers in their provider networks on nationwide basis.

    To keep the Managed Care Division’s health plans in compliance contract requirements and applicable regulations, the Director, develops processes to maintain and verify provider network data so that the plans’ provider directories and provider network reporting to CMS and DHCS are complete and accurate. The Director oversees ongoing analysis of the networks in terms of time and distance and develops strategies to address any deficiencies in the networks.

     

    The Director leads the entire provider contracting process including network analysis, determining which providers to target, recruitment activities, contract negotiation, and provider orientation to the plans.

     

    The Director demonstrates his or her success in this role by maintaining provider networks that keep AHF’s plans competitive and attractive to current and potential enrollees and its network primary care providers, as well as meeting contract requirements and applicable time and distance regulations; keeping network provider data up-to-date, complete and accurate so that AHF can publish accurate provider directories and network reports; and executing financially competitive anc cost effective contracts provider contracts.

     

    We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability.  The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.

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