Hirebridge
Director of Contracting, Targeted Drug Delivery (TDD)
Hirebridge, Milwaukee, Wisconsin, United States, 53215
Director of Contracting, Targeted Drug Delivery (TDD)
Email This Job
Your First Name
Considering making an application for this job Check all the details in this job description, and then click on Apply.
Your Last Name
Your E-Mail Address
Your First Name Your Last Name Your E-Mail Address E-Mail Address to Share With Subject Message
Director of Contracting – Targeted Drug Delivery (TDD) -This is a 100% remote opportunity AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion CareWith our diverse culture, and our values around Innovation, Stewardship, and Unity, we are committed to Advancing Quality, and Improving Lives. We are dedicated to doing more for our patients by providing quality products and services that enhance the entire care experience. The
Director of Contracting – Targeted Drug Delivery (TDD)
leads payer contracting strategy, negotiation, execution, and performance specific to targeted drug delivery services. This role is responsible for alignment of reimbursement methodologies with financial sustainability, while also driving revenue recovery efforts, and payer compliance. The Director of Contracting – Targeted Drug Delivery (TDD) works cross-functionally with executive leadership, clinical teams, revenue cycle, and legal to expand access and optimize payer performance. AIS Healthcare offers great benefits, including health, vision and dental insurance, long term disability insurance, life insurance, a vacation package, 401K plan with a generous employer match, work from home opportunity, growth, and more! Additionally, we offer a 100% work from home model. EDUCATION AND EXPERIENCE: · Bachelor’s degree in business, healthcare administration, or related field required OR 7+ years of progressive leadership experience in managed care, payer contracting, or healthcare administration. · Proven experience negotiating and managing complex payer agreements. · Deep knowledge of healthcare reimbursement models, credentialing standards, and regulatory requirements. Experience in revenue recovery, underpayment identification, claims resolution, and payer compliance. PREFERRED EXPERIENCE: · In-depth knowledge of targeted drug delivery reimbursement methodologies, payer coverage policies, and regulatory requirements. KEY RESPONSIBILITIES: · Lead payer contracting and credentialing strategy for targeted drug delivery therapies, aligning contract terms with AIS clinical, operational, and financial objectives. · Collaborate with revenue cycle management to enforce contract terms, escalate unresolved payer issues, and support recovery efforts by resolving underpayments, denials, and reimbursement discrepancies. · Maintain strong relationships with payer counterparts to resolve issues, advocate for network inclusion, influence reimbursement policy updates, and renegotiate terms. · Serve as a key escalation point, overseeing the TDD Single Case Agreement (SCA) and Letter of Authorization (LOA) processes to ensure timely execution, reimbursement integrity, and financial viability, while enhancing payer collaboration, revenue optimization and patient access. · Develop and operationalize customized payment models that align with each payer’s network criteria, including AWP-based, flat rate, or value-based arrangements, ensuring reimbursement methodologies support both payer standards and service profitability while maintaining patient access. · Oversee contract lifecycle management, including execution, performance tracking, compliance, and renewal strategies with a focus on identifying payer-specific trends and financial risks. · Support payer network credentialing and participation efforts for TDD services across all markets. · Deliver detailed reporting to executive leadership on contract performance, payer trends, revenue recovery outcomes, and strategic opportunities. · Lead cross-functional projects aimed at improving payer alignment, expanding network access, and supporting TDD service growth. · Perform additional duties as assigned by leadership to support department goals and business priorities.
#J-18808-Ljbffr
Considering making an application for this job Check all the details in this job description, and then click on Apply.
Your Last Name
Your E-Mail Address
Your First Name Your Last Name Your E-Mail Address E-Mail Address to Share With Subject Message
Director of Contracting – Targeted Drug Delivery (TDD) -This is a 100% remote opportunity AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion CareWith our diverse culture, and our values around Innovation, Stewardship, and Unity, we are committed to Advancing Quality, and Improving Lives. We are dedicated to doing more for our patients by providing quality products and services that enhance the entire care experience. The
Director of Contracting – Targeted Drug Delivery (TDD)
leads payer contracting strategy, negotiation, execution, and performance specific to targeted drug delivery services. This role is responsible for alignment of reimbursement methodologies with financial sustainability, while also driving revenue recovery efforts, and payer compliance. The Director of Contracting – Targeted Drug Delivery (TDD) works cross-functionally with executive leadership, clinical teams, revenue cycle, and legal to expand access and optimize payer performance. AIS Healthcare offers great benefits, including health, vision and dental insurance, long term disability insurance, life insurance, a vacation package, 401K plan with a generous employer match, work from home opportunity, growth, and more! Additionally, we offer a 100% work from home model. EDUCATION AND EXPERIENCE: · Bachelor’s degree in business, healthcare administration, or related field required OR 7+ years of progressive leadership experience in managed care, payer contracting, or healthcare administration. · Proven experience negotiating and managing complex payer agreements. · Deep knowledge of healthcare reimbursement models, credentialing standards, and regulatory requirements. Experience in revenue recovery, underpayment identification, claims resolution, and payer compliance. PREFERRED EXPERIENCE: · In-depth knowledge of targeted drug delivery reimbursement methodologies, payer coverage policies, and regulatory requirements. KEY RESPONSIBILITIES: · Lead payer contracting and credentialing strategy for targeted drug delivery therapies, aligning contract terms with AIS clinical, operational, and financial objectives. · Collaborate with revenue cycle management to enforce contract terms, escalate unresolved payer issues, and support recovery efforts by resolving underpayments, denials, and reimbursement discrepancies. · Maintain strong relationships with payer counterparts to resolve issues, advocate for network inclusion, influence reimbursement policy updates, and renegotiate terms. · Serve as a key escalation point, overseeing the TDD Single Case Agreement (SCA) and Letter of Authorization (LOA) processes to ensure timely execution, reimbursement integrity, and financial viability, while enhancing payer collaboration, revenue optimization and patient access. · Develop and operationalize customized payment models that align with each payer’s network criteria, including AWP-based, flat rate, or value-based arrangements, ensuring reimbursement methodologies support both payer standards and service profitability while maintaining patient access. · Oversee contract lifecycle management, including execution, performance tracking, compliance, and renewal strategies with a focus on identifying payer-specific trends and financial risks. · Support payer network credentialing and participation efforts for TDD services across all markets. · Deliver detailed reporting to executive leadership on contract performance, payer trends, revenue recovery outcomes, and strategic opportunities. · Lead cross-functional projects aimed at improving payer alignment, expanding network access, and supporting TDD service growth. · Perform additional duties as assigned by leadership to support department goals and business priorities.
#J-18808-Ljbffr