Surpass Behavioral Health · 1 week ago
Vice President of Commercial Development
Virtual NJ
Full-time
Onsite
Director/Executive
10+ years expSurpass Behavioral Health is seeking a Vice President of Commercial Development to lead the development and execution of strategies focused on payer contracting. This role is responsible for maximizing reimbursements, ensuring compliance, and optimizing payer relationships to drive overall business growth.
Health CareMental HealthTherapeutics
Responsibilities
Develops and implements comprehensive payer strategies to drive revenue growth and market expansion
Aligns payer strategies with the organization's overall goals and objectives
Leads initiatives to improve payer relationships, including negotiations, contracting, and value-based agreements
Oversees relationships with health insurance companies, managed care organizations, and other payers
Negotiates contracts, including fee-for-service, capitation, and value-based agreements
Monitors payer performance and addresses issues related to reimbursement, denials, and payment delays
Leads efforts to engage large employer groups, providing them with tailored healthcare solutions
Develops strategies to meet the healthcare needs of employer groups, including wellness programs, disease management, and cost-containment strategies
Collaborates with sales and account management teams to drive employer group growth and to support product launches and initiatives
Leverages payer consultants' insights to refine strategies, improve negotiation outcomes, and enhance payer relationships
Leads and mentors a team of professionals, including those focused on payer strategy, employer group sales, and consultant relations fostering a culture of collaboration and innovation
Develops and implements training programs to enhance the skills and knowledge of the team
Dedicated to continuous professional growth and staying updated about industry trends and regulations
Monitors market trends, regulatory changes, and competitive activities to inform payer and employer group strategies
Conducts thorough analyses of payer data to identify areas for improvement and growth
Utilizes data-driven insights to influence decision-making, strategy formulation and refines/adjusts strategies as needed to achieve optimal results
Works cross-functionally with clinical, finance, legal, compliance, and operational teams to ensure seamless alignment and execution of payer strategies
Collaborates with marketing teams to develop messaging and materials that resonate with payers and employer groups
Engages with clinical leadership to align payer strategies with clinical goals and patient outcomes
Ensures all payer strategies, contracts and employer group engagements comply with relevant federal and state laws and regulations
Stays informed about changes in healthcare laws, regulations, and policies that could impact payer strategies
Works with the legal and compliance teams to mitigate risks and ensure adherence to industry standards
Tracks the performance of payer contracts and employer group initiatives against key metrics and objectives
Prepares and presents regular reports to executive leadership on the progress, challenges, and successes of payer strategies
Provides subject matter expertise on legislation, regulation, and accreditation standards related to managed care programs and other insurance laws and regulations
Conducts competitor analyses to identify opportunities and threats in payer strategies
Develops and tracks key performance indicators (KPIs) related to payer contracts and reimbursements
Monitors the effectiveness of payer strategies and adjusts them as necessary
Provides guidance and training to staff on payer-related issues
Oversees budget planning and resource allocation for payer strategy initiatives
Evaluates and optimizes expenditures related to payer relationships
Presents updates and strategic recommendations to executive leadership and the board of directors
Plans, directs, and coordinates contract language, rate pricing, negotiations, revenue reconciliation, and payer relationship management
Leads the design, development, and distribution of database tools and applications to efficiently measure, monitor, and/or forecast structure and performance of payer contracts
Builds and maintains strong relationships with key payer partners, including but not limited to the Intake Team, clinical leadership, RCM team, and senior leadership
Operationally integrates new entities into the existing portfolio
Complies with Company’s Core Values and Core Competencies
Performs other duties as assigned by the manager
Qualification
Required
Strong analytical, negotiation, and leadership skills
Essential knowledge of managed care, billing, and operational issues in a home or specialty infusion environment
Professional-level expertise in business and healthcare administration
In-depth knowledge of managed care concepts, including value-based contracting
Strong understanding of state and federal laws applicable to managed care
Comprehensive understanding of finance, information systems, marketing, and clinical operations processes, including the regulatory environment, provider community, and payers in new markets
Detail-oriented with a professional attitude, reliability, and the ability to provide concise, accurate responses to C-Suite personnel on managed care matters
Strong management and organizational skills to effectively lead this function
Ability to follow and provide clear verbal and written instructions, with sufficient grammar and spelling skills to avoid errors or misinterpretations
Excellent interpersonal skills to support customer service, functional team needs, and teammate collaboration
Effective communication skills in English, both verbally and in writing
Mathematical and analytical abilities for problem-solving, ranging from basic to intermediate levels
Proficiency in Microsoft Excel, Word, and Outlook
Specialized knowledge of systems related to the job function
Bachelor's degree in healthcare administration, business, or a related field
10+ years in healthcare management, with a focus on payer relations or managed care
Preferred
MBA preferred
Company
Surpass Behavioral Health
Surpass Behavioral Health offers ABA therapy for children and teens with autism, focusing on impactful, tailored programs.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Daniel Byrdsong
Founder and CEO
Company data provided by crunchbase