VP Payor Relations jobs in United States
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PRISM Vision Group ยท 1 week ago

VP Payor Relations

positionNew Providence, New Jersey, United States
timeFull-time
remoteOnsite
senioritySenior Level
money$45.19/hr - $84.38/hr

PRISM Vision Group is seeking a strategic thinker and excellent negotiator for a hands-on role in payer contracting and reimbursement strategy across their multistate medical practice. This role is critical to ensuring optimal financial performance, sustainable growth, and strong relationships with Payors, while also addressing Payor inquiries and credentialing issues.

Health CareHospitalManagement Information Systems

Responsibilities

Conduct negotiations with commercial insurers, Medicare Advantage plans, Medicaid MCOs, and other payers
Develop and execute contracting strategies that align with organizational goals and market dynamics
Analyze reimbursement models and propose innovative contracting arrangements
Understand and negotiate both ideal economic and non-economic contract terms
Evaluate contract performance, rate structures, and utilization trends
Collaborate with finance and analytics teams to model financial impact of proposed agreements
Monitor Payor compliance and identify opportunities for revenue optimization
Meet goals for revenue enhancement
Partners with executive leadership, legal, revenue cycle, and clinical operations to align Payor strategies
Serve as liaison between the organization and Payor representatives
Educate internal stakeholders on contract terms, reimbursement policies, and Payor trends
Work with operations team to optimize Merit-based Incentive Payment System (MIPS) and value performance plans
Recommend and use outside services to provide market payment data and use to develop company negotiation strategies
Stay abreast of federal and state regulations affecting reimbursement and Payor contracting
Monitor competitive market activity and Payor behavior across multiple states
Provide strategic insights to inform expansion, acquisitions, and service line development

Qualification

Financial analysisContracting strategiesNegotiation skillsHealth care Payor modelsAnalytical skillsCommunication skillsLeadership skills

Required

Bachelor's degree in finance, business, or health care or related field
Track record of successful negotiations skills
Strong analytical, communication, and leadership skills

Preferred

Experience with health care Payor models including fee-for-service, capitation, bundled payments, and value-based care models

Company

PRISM Vision Group

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PRISM Vision Group is a healthcare company that specializes in comprehensive support services to eye care organizations.
dateFounded in 2008
location
New Providence, New Jersey, USA
people-size1001-5000 employees
web-link
http://www.prismvisiongroup.com

Funding

Current Stage
Late Stage
Total Funding
unknown
2025-02-04Acquired

Leadership Team

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Richard Bleicher
General Counsel & Chief Compliance Officer
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Recent News

PR Newswire
Physician Growth Partners Strengthens Eye Care M&A Track Record, Advises Spokane Eye Clinic In Partnership With PRISM Vision Group
2025-12-09
Business Wire
PRISM Vision Group Marks Milestone in National Expansion with Spokane Eye Clinic Affiliation
2025-11-07
Morningstar.com
Axia Women's Health Appoints Kyle Snook as Chief Executive Officer
2025-06-16
Company data provided by crunchbase