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EyeCare Partners · 3 weeks ago

Regional Director, Payor Contracting

St Louis, Missouri

Contract

Onsite

Director/Executive

8+ years exp

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. The Regional Director, Payor Contracting is responsible for managing payer relationships, negotiations, financial modeling, and tracking of new and existing payer contracts for a specific region, with goals of maximizing revenue and identifying new business opportunities.

Hospital & Health Care

Responsibilities

Regional oversight of the strategic development, coordination, and analysis of managed care agreements (Commercial, Medicare, Medicaid, Exchange, and Value Based) including rate development and contract negotiations while understanding key decision points and presenting them clearly when a decision needs to be made

Development and management of the region’s Managed Care Work Plan, annual contracting budget, and strategy for the assigned region(s)

Generate necessary reports for the VP and executive team. In addition, responsible for monitoring all reports, data, and information related to managed care contracting for the assigned region(s)

Assess and report progress in meeting department objectives (Budget, Strategic, etc.). Proactively manage situations impacting the ability to deliver in accordance with the work plan and the Managed Care Strategy. Ensure that leaders are informed regarding situations or issues that need to be escalated

Understands not only contracting end to end but also understands the whole Revenue Cycle continuum as well as good working knowledge of the payor’s footprint and strategies in the assigned market and have a high-level understanding of EyeCare Partners’ Clinic and ASC’s operations

Readily embrace change and be a positive role model and change leader as needed

Mentor Sr. Payor Contracting Managers, Payor Contracting Managers, and Payor Contracting Specialist, as needed, in all aspects of payer contracting activities

Serve as a company steward, be present, visit the various clinics as needed and represent the Managed Care Department in a positive and strategic manner with Regional Operations, RCM and others

Performs other related duties and special projects as assigned

Qualification

Managed care knowledgeContract negotiationsFinancial modelingRevenue Cycle ManagementStrategic thinkingMicrosoft ExcelMicrosoft WordMicrosoft PowerPointMicrosoft OutlookDecision-making skillsCommunication skillsProject managementMentoringProblem-solvingAdaptabilityTeam collaboration

Required

Proven sound judgment and decision-making skills in a timely and effective manner

Ability to gather and use pertinent data and facts to identify and solve a range of problems related to managed care strategy, contracting, and escalated issues

Extensive knowledge of managed care, reimbursement, policies, and strategies

Tenacious personality with the ability to complete projects in a timely and effective manner

Ability to identify opportunities and threats and develop and implement an action plan which may include multiple internal and external departments and participants

Proven track record of successful contract negotiations in different markets, and multiple states

Strategic thinker, able to quickly assess the situation and provide resolution

Ability to accept responsibility and hold self and others accountable

Able to work in a fast-paced environment and willing to accept new challenges and meet deadlines

Strong written and spoken communication skills

8 + years of experience in a position that is directly responsible for contract negotiations for a payor, provider, or both

Bachelor's Degree focused on health care administration, business, or finance. Will accept 10 years of progressive direct contracting experience in addition to 2 years of experience working in RCM in lieu of a degree

Proven track record of managing contract negotiations in multiple markets and states

Exceptional skills in Microsoft Excel, Word, PowerPoint, Outlook

Preferred

Additional experience in RCM and/or finance is a plus

Master's degree: MSPH, MHA or MBA preferred

Company

EyeCare Partners

At EyeCare Partners, we are on a mission to reinvent eye care by creating a network of optometry and ophthalmology practices that bring together a wealth of expertise, resources and knowledge.

Founded in 2015

St. Louis, Missouri, US

5001-10000 employees