Director of Payer Contracts / Remote

Job Description

Job Description

Overview

Key responsibilities include but are not limited to the management of the Payer Contract Administration and Payer Implementation functions as well as PBM contracting and Managed Care contracting. This is a highly visible position and will work closely with Directors of Managed Care, RCM, Sales Executive and Field Management to provide research and solutions on payer related issues.

Schedule:

Monday - Friday, 8:30am-5pm - Remote

We Offer

• Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts
• Supplemental Coverage – Accident, Critical Illness and Hospital Indemnity Insurance
• 401(k) Retirement Plan
• Company paid Life and AD&D Insurance, Short-Term and Long-Term Disability
• Employee Discounts
• Tuition Reimbursement
• Paid Time Off & Holidays

Responsibilities

• Responsible for acquisition due diligence and integration related to government and commercial payers for all lines of business
• Responsible for the pursuit of business growth related to payer contracting delivering substantial and profitable growth for the company, including opportunistically working with the field sales teams to support current and expansion markets
• Acts as payer liaison focused on addressing Home Infusion Therapy (HIT) and PBM payer needs with appropriate resources and prioritization of value-added services and products
• Oversees HIT managed care sales process, including negotiating terms with payers. Negotiations include discussion on payment rate and structure, and all aspects of contract language
• Provides insight and knowledge in order to facilitate net revenue budgeting, long term planning, and the strategic planning for the organization
• Participates in events that are important to the business, including trade shows and educational events to promote services, visibility and relevance with targeted payers
• Manages highly complex market dynamics, including HIT and PBM payer issues, state and government regulations, payment issues, etc.
• Consistently executes on business priorities and aligns team to the organizational goals
• Manages payer contracting oversight responsibilities for any contracting cycle (new and amended), and credentialing

Qualifications

• Bachelor’s degree in related field, Master’s preferred
• Minimum of five (5) years of healthcare related experience, preferably with contracting and credentialing responsibilities (managed care, government, PBM); home infusion and medical clinic experience preferred
• Excellent time management, prioritization and organizational skills
• Experience in Outlook, Word, and PowerPoint desired
• Strong organizational and interpersonal skills as well as ability to build lasting client relationships
• Well-developed planning, marketing, organizational development, and business skills
• General business and financial acumen; understanding of managed care terminology, contracting environment, procedures and workflows
• Self-motivated and results oriented
• Proficiency in Microsoft Office applications, including Excel, Word and PowerPoint
• Proficiency in SalesForce.com or other CRM applications
• Excellent verbal and written communication and presentation skills

**To perform this position will require sitting and typing on keyboard with fingers, and occasionally standing and walking. The physical requirements will be the ability to push/pull and lift/carry 1-10 lbs**