Director Of Provider Contracting And Reimbursement
Yale University
New Haven, US
On-site
Provider network development and contracting
Healthcare provider reimbursement methodologies
Claims operations and business rules
Yale University is seeking a Director of Provider Contracting and Reimbursement to oversee the development of a comprehensive healthcare provider network, manage contract negotiations, and ensure compliance with regulatory standards. The ideal candidate will have over 15 years of relevant experience in provider network management and healthcare reimbursement methodologies
Job Summary
Develop, maintain, and optimize a comprehensive healthcare provider network to support the Yale University community.
Oversee claims operations, including processing, auditing, training, quality assurance, and development of best practices that drive accuracy, efficiency, and continuous improvement.
Partner with legal, compliance, finance, and medical economics teams to structure, review, and remediate contracts and processes that protect Yale Health’s interests.
Matching Summary
Match Score: 85
Yale University is seeking a Director of Provider Contracting and Reimbursement to oversee the development of a comprehensive healthcare provider network, manage contract negotiations, and ensure compliance with regulatory standards. The ideal candidate will have over 15 years of relevant experience in provider network management and healthcare reimbursement methodologies.
Skills & Requirements
Must-have
Provider network development and contracting
Healthcare provider reimbursement methodologies
Claims operations and business rules
Financial analysis and reporting
Legal and compliance adherence
Nice-to-have
Strategic leadership and innovation
Cross-functional collaboration
Coaching and mentoring staff
Value-based care program design
Key Requirements
Bachelor's degree or equivalent combination of education and experience
15 years of relevant experience
Experience recruiting and managing provider networks
Experience negotiating, reviewing, and amending contracts