VP of RCM & Payor Relations - Virtual Dallas, Texas
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VP of RCM & Payor Relations - Virtual Dallas, Texas

Vertava Health

Location: Denton,TX, USA

Date: 2024-12-11T09:15:29Z

Job Description:

VP OF RCM & PAYOR RELATIONS

Position Summary

The Vice President of Payor Relations is responsible for defining and executing on national and regional payor strategies that deliver on organizational goals of growing revenue and optimizing payor relationships. This position will work collaboratively with Operations, Finance, Revenue Cycle Management, Clinical, and Sales teams to execute payor strategies and emerging new payor partnership opportunities. This individual will be responsible for both leading and supporting payor negotiations with an emphasis on building strong, collaborative payor relationships.

Duties and Responsibilities

* Collaboratively develop and execute national and regional payor relationship strategies with executive leadership.

* Collaborate with executive and clinical leadership, contracting team, business development, clinical, legal, quality and compliance, subject matter experts, and other teams to optimize payor relationships in line with strategic goals.

* Build and sustain high-value relationships and create collaborative partnerships with payors and other external stakeholders.

* Provide support at various levels with external payors and leverage these relationships to expeditiously resolve issues impacting reimbursement.

* Interface with external experts (e.g., health care providers, professional societies, and payors) and effectively collaborate with cross-functional teams.

* Partner with and participate in business development efforts and evaluation of expansion feasibility including proactive payor discussions.

* Advise executive leadership on emerging trends and methodologies in managed care contracting, value-based models, payor relations, and legal issues.

* Develop and maintain an account management process and practice including quarterly meetings with key stakeholders to strengthen relationships and collaboration with payors.

* Pursue and develop relationships with payors regarding new payment or collaboration opportunities that support the enterprise's strategic goals.

* Provide oversight to the assigned team by supervising, guiding, and directing teammates to be effective team members.

* Ensure that the team is equipped with the right skills, tools, and talents necessary for executing their duties.

* Uses the established people processes (performance, development, succession, and career) to ensure that the team's level of performance and capabilities meet current and future standards.

* Develop and maintain a payer database with updated contract terms, rates, and information relative to ongoing relationships with our company to ensure effective contract cycle preparation and management by our strategic and annual operating goals

Note: The essential job functions of this position are not limited to the duties listed above. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.

Skills and Abilities

* Exhibit strong written and verbal communication skills

* Exhibit basic computer skills including, but not limited to: Microsoft Office

* Expert email communication skills

* Ability to use good judgment and keep information confidential.

* Ability to react calmly and effectively in an emergency

* Ability to interact effectively with co-workers and customers, and exercise self-control and diplomacy in customer and employee relations situations

* Ability to exercise discretion as well as appropriate judgments when necessary

* Must be proactive in finding solutions

Work Environment and Physical Requirements:

* 10 - 20% travel required; Less than 10% if located in DFW.

* Vision, hearing speech, movements requiring the use of wrists, hands and fingers.

* Must have the ability to sit for extended periods.

* Light physical effort requires handling average-weight objects up to 10 lbs and some standing and walking.

* Learning, thinking, concentration, and the ability to work under pressure, particularly during busy times.

* Must be able to pay close attention to detail

Education and Required Experience

* Bachelor's Degree required, Master's preferred

* 10+ years working with insurance companies, network management or healthcare credentialing.

* 10+ years in a senior leadership role.

* Experience structuring and negotiating contracts with varying reimbursement methodologies.

* This is a drug-free workplace. All candidates must be able to pass a pre-employment drug screen and be willing to submit to a national background check. If interested in this position, please apply with a complete resume and work history. *

Disclaimer

Applicants who have been patients of any program or provider at the facility are eligible for employment under the conditions outlined below: For private practice therapy and medication management, the applicant must have discontinued and/or transferred their treatment to a provider or providers outside of the facility. For PHP/IOP services, the applicant must have been discharged from the program at least 2 years before applying for employment.

Other details

* Pay Type Salary

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* Dallas, TX, USA

* Denton, TX, USA

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* Southlake, TX 76092, USA

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