jobs

Responsibilities

This role is for someone that is passionate about technology and pragmatic about applying it to healthcare. As an architect, you will help develop the context, the end-to-end view of how the solution fits. As an engineer, you will apply existing and new technologies in novel ways to solve business problems. You will help shape and apply interoperability standards, such as HL7 FHIR, to enable the solutions to scale. You will research and introduce technologies aimed at improving our clinical solutions. For example:


Machine learning to ease the access to the most frequently applicable clinical guidance, used by our nurses, coaches, pharmacists and doctors.
SMART-on-FHIR apps to streamline provider engagement and to help customers and their care-teams manage health goals.
Tailoring of cloud-hosted solutions for telehealth, analytics, patient education and/or secure communication.
The architecture team works closely with business strategists, clinical operations and technology delivery teams, in a scaled-agile environment. As such, the ideal person for this role has experience as a software developer, as a lead engineer (design authority) and is just as comfortable working with senior executives as they are with talking tech. In this role, you will:


Produce conceptual architecture views of end-to-end system designs.
Produce solution options and drive architecture decisions that balance factors such as cost, scalability and long-term viability.
Work with delivery teams to develop technology proofs-of-concept.
Keep security and privacy front-of-mind.
Maintain architecture roadmaps for the clinical domain, based on strategy, trends and current-state technology gaps/needs.
Do you have multiple years of experience in more than a couple of the following roles or domains?


As an IT consultant, such as with IBM or Accenture
As an Enterprise Architect
On large/complex successfully delivered IT programs, as a lead solution architect
In healthcare delivery at a hospital or clinic as IT solution owner/lead
In health insurance, particularly in care management, medical management and clinical support
In healthcare interoperability standards, such as HL7 C-CDA and FHIR
Working with clinical concepts, such as SNOMED-CT, ICD10, CPT and RXNORM
Do you keep practicing and mentoring others in software development and remain versed in current languages and tools, e.g.


Typescript, HTML5, OIDC
Functional programming
AWS Lambdas, API gateway
NoSQL
Do you know your way around a good architecture documentation tool – Visio, Omnigraffle, System Architect, Confluence, etc?


If you’ve read this far and think this sounds like you, please apply.
Career@swagrass.com for an update on your application or to provide your resume you will receive a response.

POSITION REQUIREMENTS


Should possess a bachelor degree; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred.
Five years or more years contracting and negotiating experience involving complex delivery systems and organizations required.
Significant experience leading and mentoring others.
Experience in developing and managing key provider relationships
Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
Intimate understanding and experience with hospital, managed care, and provider business models.
Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations.
Customer centric and interpersonal skills are required.
Demonstrates managerial courage as well as an ability to maneuver effectively in a changing environment.
Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
Knowledge and use of Microsoft Office tools.

DUTIES AND RESPONSIBILITIES

Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
May lead a team with direct reports.
Point person for complex projects related to contracting strategy in the market.
Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements.
Contributes to the development of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Swagrass's competitive position.
Creates and manages initiatives that improve total medical cost and quality.
Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
Creates “HCP” agreements that meet internal operational standards and external provider expectations. Ensures the accurate implementation, and administration through matrix partners.
Leads in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
Manages key provider relationships and is accountable for critical interface with providers and business staff.
Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.

Requirements

5 or more years of work experience with 1-2 years of management experience required Demonstrated ability to achieve and exceed Plan sales goals
Strong analytical, critical thinking, communication (written and oral) and organizational skills High level of interpersonal skills to handle sensitive and confidential situations and information Strong time management and organization skills he edit.
If you require an accommodation based on your physical or mental disability please email: Info@swagrass.com for an update on your application or to provide your resume as you will not receive a response.

Responsibilities

80% Production and people management focus, driving to achieve and exceed the new sales Plan goal
20% strategy focus - 3-6 month planning with agents and senior management to effectively build and drive the market business strategy and drives sales
Plans and executes the local field sales strategy to achieve and exceed the Plan sales goal by supporting representatives in building their book of business and optimizing sales opportunities
Develops, motivates, evaluates and coaches Sales Team on lead generation, conversion rate, community and provider development, sales techniques, compliance and performance goals. Is visible and available to staff to answer questions, evaluate results, resolve escalated calls and give ongoing consistent feedback. Schedules formal one-on-one meetings to review and discuss performance to key metrics; goal attainment and career development.
Drives team usage and understanding of systems, policies, programs and procedures knowledge. Manages and monitors daily workflow and reporting to ensure business objectives are maintained and accurately reported.
Develops and maintains strong collaborative relationships with internal business partners and external key contacts to develop and drive additional lead generation and sales opportunities, maintain excellent lines of communication and provide insight and impact.
Use reporting tools, product knowledge, and sales strategies to coach, mentor and motivate sales agents.

Requirements

POSITION REQUIREMENTS


Should possess a bachelor degree; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred.
Five years or more years contracting and negotiating experience involving complex delivery systems and organizations required.
Significant experience leading and mentoring others.
Experience in developing and managing key provider relationships
Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
Intimate understanding and experience with hospital, managed care, and provider business models.
Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations.
Customer centric and interpersonal skills are required.
Demonstrates managerial courage as well as an ability to maneuver effectively in a changing environment.
Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
Knowledge and use of Microsoft Office tools.

Responsibilities

DUTIES AND RESPONSIBILITIES

Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
May lead a team with direct reports.
Point person for complex projects related to contracting strategy in the market.
Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements.
Contributes to the development of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Swagrass's competitive position.
Creates and manages initiatives that improve total medical cost and quality.
Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
Creates “HCP” agreements that meet internal operational standards and external provider expectations. Ensures the accurate implementation, and administration through matrix partners.
Leads in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
Manages key provider relationships and is accountable for critical interface with providers and business staff.
Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.