Vice President - Payer Strategy and Relationship

Vice President - Payer Strategy and Relationship

Downers Grove, IL

OVERVIEW:

The Vice President of Payer Strategy and Relationship will direct efforts to coordinate and negotiate hospital, physician and ancillary service agreements that are in accordance with Vein Clinics of America standards and state and federal guidelines, in order to maintain and enhance the provider network and to meet/exceed accessibility, quality and financial goals. Maintain close relationships with contractors and key provider groups. Manage team of contracting professionals. 

Responsibilities:

  • Lead all VCA Payer Strategy and Relationship efforts.
  • Develop a comprehensive strategic plan to position VCA and the benefits of VCA’s approach and medical protocol with the Payer Partners.
  • Build solid relationships with all key Payer Partners to assist with all aspects of our Payer relationship, including contract negotiations, resolving payment issues, executive level contacts, etc.
  • Proactively track and report all contracting efforts and the strategy at large. Conduct regular status updates with core team members and provide management with a clear sense of progress and understanding of any marketplace changes (major insurance changes, network and reimbursement issues, changes in legislation or in guidelines at the federal levels) during the course of the performance year.
  • Manage the contracting administrative team and ensure timely and accurate loading of contracts and rates. 
  • Analyze current Payer contracting and propose new and better strategies to enhance year over year performance.
  • Assist the executive team in developing contacts and relationships for the payer markets in newly targeted regions as needed.
  • Communicate key trends and industry changes to the EMT and broader organization on a regular basis.
  • Other duties as assigned.

Requirements

 

Position Qualifications:

  • Four (4) year bachelor’s degree in healthcare administration, business administration, marketing or related field and ten (10) years healthcare industry experience.
  • Multi-state payer experience
  • Knowledge of contracting/sales, provider customer service, standard credentialing procedures, and marketing.
  • Knowledge of healthcare contracting language and the principles of negotiation and the ability to understand different types of reimbursement models.
  • Must be able to apply corporate policies and procedures to solve practical problems.
  • Ability to negotiate effectively.
  • Must be proficient in Word, Excel, PowerPoint, and Outlook.
  • Superior written and oral communication skills.
  • Ability to interpret and compose spreadsheets, reports and presentations.
  • Strong analytical, problem solving and project management skills.
  • Must be able to meet deadlines and work under pressure with little to no direct supervision.

Preferred, but not required:

  • Knowledge of healthcare finance principals
  • Knowledge of healthcare quality initiatives
  • Knowledge of performance-based contracting
  • Existing healthcare relationships
  • Master’s degree in healthcare administration, business administration, marketing or related field