Abbott · 4 days ago
Director, Payor Relations & Regulatory Affairs
Livermore, CA
Full-time
Onsite
Director/Executive
$172K/yr - $344K/yr
10+ years expAbbott is a global healthcare leader that helps people live more fully at all stages of life. The Director, Payor Relations and Regulatory Affairs will be responsible for developing strategies to maintain and expand payor coverage while ensuring compliance with required standards. This role includes overseeing contracting and regulatory affairs processes across the organization.
BiotechnologyEmergency MedicineGeneticsHealth CareHealth DiagnosticsManufacturingMedicalMedical DeviceNutritionPharmaceutical
Responsibilities
Directly hires, develops, and drives engagement for team members across Payor Relations and Regulatory departments
Oversees essential activities and process improvement related to commercial payor contracting across all lines of business; specific contracting activities include, but are not limited to :
Contract redlining
Contract implementation
Contract monitoring
Contract management, including initial & ongoing credentialing
Payor escalation management, including payment discrepancy resolution
Oversees essential activities and process improvement related to regulatory affairs for ACH; specific contracting activities include, but are not limited to :
State licensing
Medicare and Medicaid enrollments
The Joint Commission Accreditation
Maintains governance processes to ensure alignment to contracting and regulatory business expectations with cross-functional stakeholders, including : finance, commercial operations, revenue cycle management, legal, and the office of ethics & compliance
Develops, maintains, and presents to leadership the KPIs/metrics related to areas of responsibility
Contributes to business strategies related to commercial contracting, payor management, and regulatory compliance; examples include : patient access, pricing, payor management, Medicaid advocacy, state licensing applications, and accreditations
Qualification
Required
Bachelor's Degree in a business discipline
10+ years relevant experience in payor contracting at a healthcare provider, payor, or network
5+ years directly interacting with regulatory agencies
Demonstrated ability to develop, improve, and monitor commercial contracting processes
Ability to work independently and managing competing priorities routinely
Preferred
Master's Degree in related field
5+ years experience in payor contracting within the DME/IDTF provider space
5+ years experience working directly with CMS (Medicare/Medicaid), The Joint Commission, and state licensing agencies
Benefits
FREE coverage in our HIP PPO medical plan
Company
Abbott
Abbott is a healthcare company that produces diagnostic kits, medical devices, nutritional products, and branded generic medicines.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$6.79M2011-03-15Post Ipo Debt· $0.1M
2009-03-16Post Ipo Debt· $6.69M
1980-12-12IPO
Leadership Team
Robert Ford
President & Chief Executive Officer
Mike Peterson
Senior Vice President
Recent News
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