Payor Strategy Leader - Remote

Overview

As a payor strategy leader, you will drive our payor strategy and help deepen and broaden our accessibility to more prospective patients. You have a proven history of leading payor contracting, including direct negotiations with national / local players and have strong knowledge of healthcare service payment strategies.

In Short

• Expand and develop a strategy for payor contracting across existing and new health plans
• Proactively research, identify, build, and maintain relationships with key stakeholders at target health plans to identify opportunities for collaboration and partnership
• Develop individualized partnership proposals tailored to the needs of target health plans, keeping in mind the overall goal of increasing access to and delivering quality healthcare services
• Negotiate new contracts and more favorable rates to ensure maximum revenue and operational efficiency and compliance
• Direct and support the launch of new markets / new states via contracting with local, regional, and national payors
• Act as a highly metrics and process driven leader, optimizing collections and insurance / verification while working closely with the RCM team to develop a cohesive end to end reimbursement process
• Create, drive, and track KPIs and quality indicators for payors including contract volumes, rates and benchmarks
• Identify, track, and manage all contracts and contract terms; develop ongoing strategies for better contracting maintenance processes
• Maintain expertise with FFS and, when appropriate, risk based contracting (VBC) payments relative to dietician practice performance, member experience measures, clinical quality measures, and other related measures that drive total cost of care
• As the company continues to grow, recruit, retain, and mentor a top-tier payer function and team that can successfully scale with the organization

Requirements

• Proven history of leading payor contracting
• Strong knowledge of healthcare service payment strategies
• Experience in direct negotiations with national/local payors
• Ability to develop and maintain relationships with stakeholders
• Metrics and process-driven leadership skills
• Experience in contract management and optimization
• Ability to create and track KPIs
• Expertise in FFS and risk-based contracting
• Leadership experience in recruiting and mentoring teams

Benefits

• Opportunity to work with a dynamic team
• Potential for career growth and development
• Flexible working environment
• Competitive compensation package
• Access to healthcare benefits