Senior Payor Strategy Specialist
$85,000–$105,000 year
Remote
Job Summary
Formulate and execute comprehensive payor strategies and business plans to drive departmental sales goals across Medicare, Medicaid, Commercial, and Managed Care Organizations. Initiate, negotiate, and execute complex payout contracts, letters of agreement, and revisions based on claims volume and market trends. Establish and nurture regional account relationships while utilizing financial modeling to assess rate structure sustainability. Contract with new partners to implement bundled or value-based pricing strategies and ensure all contract language aligns with company interests. Partner with internal teams including Revenue Cycle Management, Licensing, and Compliance to ensure end-to-end contract alignment and execution. Document all designated profiles and sales forecasting data in CRM applications. Maintain regular attendance and complete all assigned duties as required.
Required Qualifications
- Bachelor's degree
- 5+ years of business development experience in the payor sector
- Existing relationships with, and experience selling value-based products/services to Regional Payors
- Ability to review contracts, respond with readiness, and negotiate win-win deals with Payors
- Prior experience working with Revenue Cycle Management teams and contract implementation
- Strong communicator who can proactively identify potential challenges and think creatively about solutions
- Team player that is highly collaborative, goal-oriented, and confident
- Ability to receive feedback and take constructive steps to improve skill sets as needed in a fluid and changing environment
- Self-starter who thrives when given autonomy but able to escalate as appropriate and is comfortable with ambiguity
- Skilled at documentation and familiar with use of a CRM, attention to details
- Able to manage multiple tasks simultaneously and effectively
- Possesses prioritization skills to meet long-term and short-term goals
- Consistent access to a private work environment with high speed internet and professionally appropriate surroundings for frequent video conferencing and a workstation setup conducive to remote work needs
- This is a full-time (40hrs per week) remote position
Desired Qualifications
- Value-based care experience is a plus
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