Director Of Provider Contracting And Reimbursement

Yale Health

New Haven, CT, US
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Provider network development and contracting
Healthcare claims and business rules
Provider reimbursement methodologies
** Yale Health is seeking a Director of Provider Contracting and Reimbursement to develop and manage its healthcare provider network. The ideal candidate will have over 15 years of relevant experience and a strong background in provider network development, contract negotiation, and claims operations. **

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: 75

** Yale Health is seeking a Director of Provider Contracting and Reimbursement to develop and manage its healthcare provider network. The ideal candidate will have over 15 years of relevant experience and a strong background in provider network development, contract negotiation, and claims operations. **

Skills & Requirements

Must-have

  • Provider network development and contracting
  • Healthcare claims and business rules
  • Provider reimbursement methodologies
  • Financial reports analysis
  • Strategic leadership and performance management

Nice-to-have

  • Innovation and continuous improvement
  • Coaching and mentoring skills
  • Effective communication with diverse audiences
  • Big picture thinking and forward-looking strategies

Key Requirements

  • Bachelor's degree and 15 years of relevant experience
  • Experience in provider network development and contracting
  • Experience in healthcare claims operations
  • Knowledge of healthcare provider or health plan accounting/finance
  • Advanced knowledge of fiscal and regulatory compliance

Work Rights

Not specified

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