Simplifying Complex Care
Senior Director, Payor Relations
Location
United States
Posted
17 days ago
Salary
$125K - $170K / year
Seniority
Senior
Job Description
Senior Director, Payor Relations
Soleo Health
• Formulate and oversee the implementation of comprehensive regional and national Payor contracting and network management strategies • Drive the achievement of contracted sales goals and enhance market share and profitability • Lead the identification, development, negotiation, and management of Payor Relations agreements to ensure competitive and sustainable growth • Initiate and guide the launch of innovative Payor relations programs and contracts, collaborating with senior internal stakeholders including operations, finance, and Regional Vice Presidents • Oversee detailed financial analyses of Payor contracts to assess the earnings impact of new contracts, as well as renewals and material network changes • Manage budget projections for pricing and assess financial performance of payor contracts • Ensure Payors are reimbursing Soleo at the contracted rates and that reimbursement is timely • Enhance Soleo’s contracting strategy to maximize value (where applicable) using national contracts with chain codes vs. individually contracted pharmacies • Serve as the primary executive contact for major external partners, including hospitals, Payor organizations, and manufacturers • Build and maintain strategic relationships to bolster business objectives • Oversee the design and implementation of advanced sales training programs that focus on Payor relations, contract comprehension, opportunities, and associated risks • Monitor and analyze market trends and contractual activities to identify and seize opportunities for new or expanded Payor agreements • Lead the development of performance-based contracting models that reflect the latest in healthcare industry advancements and match organizational goals (i.e., Soleo’s participation in limited payor networks) • Maintain and update the company's strategy in response to healthcare legislation changes • Act as a subject matter expert to guide Payor Relations policies and practices • Manage the creation and ongoing updates of departmental policies to ensure compliance with regulatory, operational, and organizational standards • Partner with Revenue Cycle Management team to defend Soleo’s interests in payor audits • Manage the creation and ongoing updates of departmental policies to ensure compliance with regulatory, operational, and organizational standards • Completes all necessary managerial tasks for direct reports including hiring, training, addressing performance issues, developing team goals and objectives, performance reviews, conflict resolution, and strategic planning
Job Requirements
- Bachelor’s degree in a related field such as business administration, economics or finance
- Minimum of 10 years in Payor Relations and Contracting including significant leadership experience in complex healthcare environments
- High school diploma (or equivalent) required
- Advanced degrees such as an MBA or Juris Doctorate preferred
- Strong communication, negotiation, and leadership skills
- Proven track record of leading high-performing teams and effectively managing senior-level projects and initiatives
- Exceptional capability in analyzing complex data, identifying strategic insights, and employing them to improve business performance and operational efficiencies
- Expertise in developing and delivering strategies and business plans to a variety of stakeholders, including executive leadership, board members and external partners
- Operates effectively and successfully in fast-paced high growth environment
- Capable of managing multiple, high-stakes projects in parallel with one another
- Willingness and ability to travel extensively, often exceeding 50% of the time, to meet business needs
Benefits
- Competitive Wages
- 401(k) with a Match
- Referral Bonus
- Paid Time Off
- Great Company Culture
- No Weekends or Holidays
- Paid Parental Leave Options
- Affordable Medical, Dental, & Vision Insurance Plans
- Company Paid Disability & Basic Life Insurance
- HSA & FSA (including dependent care) Options
- Education Assistance Program
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