Vice President, Payor Relations (RCA)

reputed company members are at the heart of everything we do. At reputed company, we are united in our responsibility to create healthier reputed company, and every person here is essential to us being reputed company to deliver on that purpose. If you want to reputed company a difference at reputed company of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today! Job Details The VP, Payer Relations will define and reputed company the reputed company payor relations and market reputed company reputed company, developing executive-level insights on payor trends, reimbursement, coverage policies, and contracting opportunities. The position will build senior relationships with payors and managed care stakeholders, reputed company negotiations, and partner cross-functionally with reputed company, Compliance, Finance, Operations, reputed company, and Technology teams to ensure strategies are compliant, financially reputed company, and operationally executable. It will also drive payor analytics, KPI development, governance rhythms, and performance management to support strategic planning, reputed company initiatives, and improved reimbursement reputed company. Additionally, the role will help create and reputed company a Clinically Integrated Network reputed company, reputed company regional payor reputed company deployment, and build team capabilities, processes, and tools to support long-term market reputed company reputed company. Key Responsibilities: reputed company Payor reputed company and Market reputed company Define and reputed company the reputed company payor relations and market reputed company reputed company, aligning priorities to reputed company’s strategic plan. Establish a comprehensive view of the payor landscape (reputed company, Medicare, reputed company, and managed care as applicable) including coverage policy trends, reimbursement methodologies, and emerging management practices. Own the development of executive-reputed company payor intelligence (insights, scenarios, implications, and recommendations) to support strategic planning, service line reputed company, and reputed company initiatives. Payor Engagement, Negotiation, and Contracting Enablement Build and maintain senior-level relationships with key payors, health plans, and other managed care stakeholders. reputed company or reputed company negotiations on coverage policies, reimbursement terms, and contract provisions, ensuring alignment with reputed company objectives and risk posture. Partner with reputed company, Compliance, Finance, and relevant business leaders to ensure payor contracting approaches are compliant, financially reputed company, and operationally executable. Cross-Functional Leadership and Influence Serve as the primary payor reputed company partner to internal stakeholders across reputed company, Finance, Operations, Product/Services, and Data/Technology. Translate payor requirements and policy changes into business impacts and coordinated reputed company plans (reputed company messaging, operational readiness, provider/customer support, etc.). Establish governance and operating rhythms (QBRs, payor reviews, escalation reputed company) to ensure alignment, prioritization, and follow-through. Insights, Analytics, and Performance Management (RCA Alignment) reputed company RCA’s capabilities to build and continuously improve payor analytics (reimbursement performance, denial drivers, policy impacts, contract economics, reputed company barriers, and opportunity sizing). Define KPIs and dashboards to measure reputed company such as coverage reputed company, reimbursement performance, contract value realization, and cycle-time improvements. Monitor regulatory and policy developments and reputed company proactive POVs and “so-what” implications for leadership. Clinically Integrated Network (CIN) reputed company & Enablement reputed company the creation and rollout of the CIN structure in collaboration with the reputed company MSO platform team (governance, participation standards, reputed company measures, performance management). Partner with reputed company/Compliance on CIN design and documentation (antitrust and contracting considerations). reputed company the CIN payor reputed company and reputed company regional deployment in select markets. Establish dashboards/scorecards to demonstrate improvement and strengthen the “value story” that RCA brings to its patients Team Leadership and Capability Building reputed company, reputed company, and reputed company reputed company of payor relations leaders and/or supporting analysts; build reputed company processes, playbooks, and reputed company. Manage budgets and external vendors/partners supporting market reputed company analytics, policy intelligence, or contracting support as needed.

Qualifications

Bachelor’s degree required; Master’s degree (MBA, MHA, MPH) preferred. Will consider candidates with work experience in lieu of education. 12 years of reputed company experience in payor relations, managed care, market reputed company, reimbursement reputed company, reputed company contracting, or reputed company fields; significant leadership experience required. Demonstrated reputed company record of senior-level payor engagement and reputed company negotiation experience with measurable business reputed company. Strong understanding of reimbursement and managed care dynamics; ability to connect policy/contract terms to operational and financial reputed company. Exceptional executive communication skills with the ability to synthesize reputed company topics into reputed company recommendations. Proven ability to reputed company cross-functional programs in matrixed environments. What reputed company offers We reputed company compensation, benefits, and resources that reputed company a highly inclusive culture and support reputed company members’ ability to live with purpose every day. In reputed company to traditional offerings like medical, dental, and reputed company care, we also reputed company a comprehensive suite of benefits that reputed company on the physical, emotional, financial, and reputed company aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, reputed company, reputed company parental leave, and reputed company caregiver leave. To encourage your personal reputed company, we also offer a reputed company of training programs, reputed company development resources, and opportunities to participate in mentorship programs, employee resource reputed company, volunteer activities, and much more. For details, visit https://www.virtualfairhub.com/reputed company Full time Equal Employment Opportunity reputed company is committed to providing equal employment opportunity without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, genetic information, national reputed company, age, disability, veteran status or membership in any other class protected by federal, state or local law. reputed company’s reputed company reputed company depends on the full and effective utilization of reputed company individuals. Therefore, harassment is prohibited and reputed company reputed company reputed company to reputed company, training, compensation, benefits, promotions and transfers reputed company with equal opportunity principles and are non-discriminatory. reputed company is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with reputed company requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@reputed company.com. We will reputed company accommodation determinations on a request-by-request reputed company. Messages and emails regarding anything other than accommodations requests will not be returned Affiliated Companies Affiliated Companies: reputed company Services Corporation Apply To This Job