[Hiring] Director of Payor Contracting & Population Health @Cencora

Role Description

The Director of Payor Strategy and Population Health is responsible for leading Managed Care Negotiations and Relationship Maintenance, including reimbursement rates, administrative requirements, language, and terms. This role serves as the primary liaison with payors for all issues beyond contracting, including escalation of disputes and problems, innovative business relationships, and other direct engagements with the payors and intermediate entities on behalf of our national team.

This position represents a significantly rewarding career opportunity to join the largest and fast-growing retina practice management company, admired for its people, partnership model, and performance - Retina Consultants of America.

• Assess macro trends and market specific nuances to determine opportunities by market and payor.
• Craft a compelling pitch to meet and exceed goals for rates, prior auth pass/gold-carding, population health incentives, etc.
• Review health plan agreements and fee schedules of acquisition targets to assess and craft recommended integration strategies to optimize value to stakeholders.
• Represent Retina Consultants of America and our regional teams in negotiations with managed care and intermediary relationships nationally.
• Maintain contract management platform with all agreements and fee schedules.
• Work with Financial Planning and Analytics to verify the financial impact of new contracts and to develop budgets based on confidence in future year(s) proposals.
• Collaborate closely with cross-functional and national stakeholders to monitor and report on key market trends.
• Prepare reporting and analytics to support and justify recommendations for internal and external use.

Qualifications

• Bachelor’s Degree in accounting, finance, or business administration.
• A Master’s degree in Business, Healthcare, Public Health Administration is preferred, but not required.
• 5+ years of contracting, negotiations, and health plan portfolio management experience in specialty medicine, private equity, or health care contracting.
• Deep experience in understanding healthcare field – understanding parameters around how payers and providers are working.
• Experience in a high growth, fast-paced, high pressure, constantly changing environment; private equity and or start-up experience preferred.

Requirements

• Strong analytical skills, with extreme attention to detail, accuracy and accountability balanced with sound business judgment.
• Ability to take ownership over health plan relationships for the purposes of negotiations.
• Demonstrated ability to leverage data, insights, and effective communication strategies to influence stakeholders.
• Possess a strong detail orientation; seeks appropriate amount of data and information to make decisions.
• Ability to build constructive relationships in furtherance of organizational goals and priorities.
• Adept at managing highly collaborative, matrix relationships across the organization.
• Possess strong interpersonal skills to effectively collaborate with cross-functional teams.
• Excellent professional written/verbal communication and interpersonal skills.
• Commitment and ability to work hands-on with a sense of urgency.

Benefits

• Compensation, benefits, and resources that enable a highly inclusive culture.
• Traditional offerings like medical, dental, and vision care.
• Comprehensive suite of benefits focusing on physical, emotional, financial, and social wellness.
• Support for working families, including backup dependent care, adoption assistance, and infertility coverage.
• Paid parental leave and paid caregiver leave.
• Variety of training programs, professional development resources, and mentorship opportunities.