Fortrea · 1 day ago

Executive Director Strategic Payer Initiatives

Remote_United States

Full-time

Onsite

Director/Executive

$180K/yr - $220K/yr

10+ years exp

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Responsibilities

Responsibility for the development of a comprehensive value proposition that combines Labcorp’s population Health analytic tools, Lab Stewardship, and Gap-In-Care programs and other applicable products and services.

Responsibility for the continued implementation and expansion of our Gaps-In-Care solutions with Payors. Payor clients would span national and Regional Clients.

Design and execute on growth strategies targeting gaps-in-care, health equity and SDoH issues impacting our payor clients.

Leverage Real-world data (e.g. CMS Star ratings, NCQA ratings, etc.) to understand national and regional Gaps-In-Care and opportunities. Capture insights systematically translate these insights into actionable activities to grow the business

Oversee our Stewardship initiatives, which includes working with third party vendors like Avalon, partnerships with other outside intermediaries, ACLA and our internal government affairs team.

Work cross-functionally with internal medical support teams, legal, marketing, regional division leadership, kit vendors, and client support/success to ensure operational excellence and various budget metrics are exceeded.

Partner with Payor Solutions VPs and Directors as applicable on messaging and approach to identified targets.

Manage a team of professionals responsible for sales, negotiating agreements for new products/services, implementation, and account management with focus on retention and upselling.

Oversee program enhancements working with various stakeholders across the company including but not limited to our scientific and medical teams, payor solution executives, and sourcing and procurement. This would also include the evaluation of partnerships with external vendors, companies, or platforms.

Drive program improvements to improve customer value prop and reduce inefficiencies

Managed the budget to meet company metrics and make recommendations on resource allocations to ensure external and internal needs are being met.

Present insights and reports, KPIs to senior leadership highlighting successes and areas needing attention. Submit executive budget on time addressing various company goals and requirements.

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.

Population HealthValue-Based CareHealthcare Quality InitiativesProgram Budget ManagementHEDIS ReportingSTARS RatingsCost-Benefit AnalysisMicrosoft OfficeProject Management CertificationCare Management CertificationSDoH Understanding

Required

Bachelor's degree

10 years of relevant experience in healthcare, preferably in diagnostics, with a health plan, in population health, value-based care, or a combination.

5 years of experience in a People Leader role

Experience managing program budgets, performing cost-benefit analysis and optimizing ROI for healthcare initiatives

Understanding of the current diagnostic market and the relationship laboratories and diagnostics play in the health care delivery models that exist in the U.S.

Thorough understanding for the U.S. Health Care market, relationship between Health Plan, Member, Employer

Experience with quality measures, HEDIS reporting, STARS ratings, and the analysis of metrics like patient engagement, adherence, and outcomes.

Understanding of compliance requirements related to healthcare quality (e.g. NCQA, CMS).

Strong Microsoft Office skills (e.g. Excel, Word, PowerPoint)

Strong communication skills, written and oral, ability to present to executive level strategy and budget goals.