Manager of Payor Contracting

Manager of Payor Contracting

Requirements

• Minimum BA/BS in Business Administration, Healthcare Administration or related degree
• Minimum five years experience negotiating payor and/or provider agreements
• Experience managing relationships and agreements
• Knowledge of managed care regulations and laws related to health care, preferably in behavioral health
• Experience with alternative payment models, such as Value Based Programs, Risk Arrangements, and Case Rates
• Ability to work remotely and to travel to the corporate office and to payor visits or conferences
• Strong negotiation and interpersonal skills: written, verbal, analytical
• Motivated and influential – proactive with the ability to adhere to deadlines; work to “get the job done” in a fast-paced environment
• Self-starter with the ability to multitask.

Responsibilities

• Strategically determine where SonderMind could strengthen its in-network participation with payors and engage with new payors to secure in-network agreements.
• Develop and analyze complex data sets for use with rate modeling, proposal preparation, and negotiations.
• Lead, develop and identify negotiation strategies to optimize partnership opportunities with key payors, while working collaboratively with internal stakeholders to execute and manage such arrangements.
• Cultivate relationships, build partnerships and maintain strong communication with payors. Develop materials used for presentations and lead monthly/quarterly meetings.
• Review and analyze contract language and reimbursement terms in existing and potential payor agreements. Recommend modifications that support the business objectives and benefit the company.
• Collaborate with and support internal cross functional teams, such as Revenue Cycle, Credentialing, Finance and Legal. Identify areas requiring cross functional problem solving and initiate solutions.
• Investigate and understand payor market dynamics in different states (payor mix changes, reimbursement issues, product offerings and state regulatory statutes) that will enable you to develop clear value propositions to enhance partnerships with payors.
• Own the end to end negotiation and renegotiation process to include application process to initiate new agreements to operationalizing new agreements and/or amendments. This includes loading data into the contract management system and preparing contract summaries of financial and administrative terms.
• Other responsibilities and ad-hoc projects based on business needs.

Preferred Qualifications

No preferred qualifications provided.