40 applicants

Company

WellNow Urgent Care · 4 hours ago

Senior Manager, Payor Strategy

NY - Remote

Full-time

Remote

Senior Level

$115K/yr - $130K/yr

6+ years exp

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Responsibilities

Responsible for working with Vice President + Senior Vice President of Payor Strategy on managing the contract portfolio for Aspen Dental.

This includes pursuing and preparing for renewals, assisting in the implementation and execution of new contracts, as well as all necessary contractual amendments, changes, and renewals.

Assists in managing the relationship with plans and finding solutions for operational challenges they face.

Develops and maintains effective working relationships with insurance company and managed care company personnel responsible for contracting with healthcare providers.

Manage the implementation, execution, and communication of contracts throughout organization.

Act as an expert resource on escalated contractual issues in addition to resolution of high-level compliance and customer-related concerns.

Responsible for managing payor contract portfolios on a regular basis including monitoring, tracking, and touchpoints.

Support ongoing payor negotiations including language, rates, amendments, etc. as needed with leadership.

Monitor contract performance and other provisions to assure compliance, identify problem areas, and resolve disputes.

This position is responsible for managing and completing major departmental projects including recommending project plans and recommending resource allocations.

Resolve escalated contract issues generated by operational department heads.

Draft and communicate customer announcements for newly executed, terminated, or revised/updated contracts and payor industry news.

Work collaboratively with payors and Aspen Department Leadership (i.e Legal/Compliance, Finance, Centralized Billing, and IT) on strategic business development efforts to ensure geographic maximization, plan and service types, and optimal reimbursement rates.

Other duties as assigned.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Managed care contractingHealthcare insurance knowledgeNegotiation techniquesProject managementMicrosoft Office Suite

Required

Bachelor's degree

6-8 years of progressively responsible management or supervisory level managed care contracting experience in a payor or health care setting with at least five (5) of these years' experience in a medium to large health system.

Broad knowledge of healthcare insurance, physician billing and reimbursement, administration, systems, practices and principles, (i.e. Medicaid, Medicare, Medicare Advantage, and Commercial.)

Knowledge and ability to effectively utilize negotiation techniques and practices to effectively advocate for providers.

Excellent verbal & written communications

Excellent time management, prioritization, and organizational skills a must.

Detail oriented with a strong level of analytical, and problem-solving skills

Proficient use of Microsoft Office Suite.

Company

WellNow Urgent Care

Glassdoor

2.6

WellNow Urgent Care is one of the fastest-growing providers of urgent medical care, virtual care, occupational health services and clinical research in the United States.

Founded in 2011

Nashville, Tennessee, USA

1,001-5,000 employees