92 applicants

Company

Cerebral · 5 hours ago

Director, Strategic Payor Partnerships

Remote (United States)

Full-time

Remote

Director/Executive

$170K/yr - $195K/yr

7+ years exp

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Responsibilities

Develop and Execute Partnership Strategy: Lead the development and execution of a comprehensive partnership strategy to drive growth and enhance Cerebral's market position within the Insurance space. Identify opportunities for contracts with insurance providers aligned with business objectives.

Build and Maintain Relationships: Cultivate and maintain strong relationships with insurance providers, including payers, health plans, and managed care organizations. Serve as the primary point of contact for key partners, establishing new contracted coverage, and fostering collaboration and alignment on strategic initiatives.

Negotiate Partnership Agreements: Lead negotiations with insurance providers to establish mutually beneficial partnership agreements. Collaborate with legal and finance teams to structure agreements that support Cerebral’s growth objectives, while mitigating risks.

Drive Revenue Growth: Develop and implement initiatives to drive revenue growth through strategic insurance partnerships. Identify opportunities to expand product offerings, increase market share, and generate new revenue streams in collaboration with insurance partners.

Strategic Planning and Analysis: Conduct market research and analysis to identify emerging trends, opportunities, and threats in the insurance landscape. Develop a strong understanding of competitor offerings and customer preferences. Utilize insights to inform strategic decision-making, product development initiatives, and to optimize partnership strategies.

Collaborate with Cross-Functional Teams: Partner closely with cross-functional teams, including product development, marketing, finance / billing, and operations, to ensure alignment of partnership initiatives with overall business goals. Collaborate on product development, go-to-market strategies, and client engagement efforts.

Monitor and Evaluate Partnership Performance: Track and evaluate the performance of insurance partnerships against established KPIs and objectives. Act as a liaison between Cerebral and insurance partners to resolve issues and drive mutual success.

Optimize Revenue Cycle: Collaborate with finance and revenue cycle management teams to optimize insurance reimbursement processes and maximize revenue generation. Identify opportunities to optimize claims efficiency and minimize errors for revenue enhancement and cost containment.

Ensure Compliance: Work with legal and compliance teams to stay abreast of regulatory changes and industry standards pertaining to insurance practices.

Provide Leadership and Mentorship: Lead cross-functional team working on our insurance “relaunch,” providing project management, expectation setting, and team development to support the launch. Foster a collaborative and inclusive team culture focused on continuous improvement and excellence.

Start-Up Experience: Experience in start-ups or ability to move quickly despite insurance being a traditional industry.

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.

Insurance managementStrategic partnership developmentHealthcare industry experiencePayer contract negotiationsHealthcare insurance landscapePatient insurance lifecycleCMS EDI StandardsMental Healthcare carveout programsHealth Insurance TechnologyClinician credentialingStart-Up experienceStrategic thinkingLeadership experience

Required

Bachelor's degree in Business Administration, Healthcare Administration, or related field; Master's degree preferred.

Minimum of 7 years of experience in insurance management, strategic partnership development, business development, or related roles within the healthcare industry.

Deep understanding of the healthcare insurance landscape, including knowledge of payer dynamics, reimbursement models, and regulatory requirements.

Proven track record of building and managing successful partnerships with insurance providers.

Understanding of the full patient insurance lifecycle, including eligibility and benefit verification, claims submission, and claims processing.

Experience in payer contract negotiations and management, especially with major networks such as BCBS, Cigna, Aetna, Magellan, and UHC.

Interpretation of CMS EDI Standards: Knowledge in interpreting CMS EDI standards, such as EDI 270/271.

Experience with working with Mental Healthcare carveout programs for insurance eligibility and billing.

Experience working with Health Insurance Technology and vendors, including experience with Real-Time eligibility, Automatic Claims processing, and workflow optimization.

Experience with clinician credentialing and delegation agreements.

Strong negotiation skills, with the ability to structure and execute complex partnership agreements.

Strategic thinker with the ability to identify and capitalize on market opportunities.

Excellent communication and interpersonal skills, with the ability to effectively engage and influence internal and external stakeholders.

Strong analytical skills, with the ability to analyze market trends, financial data, and performance metrics to drive decision-making.

Leadership experience, with the ability to lead cross-functional teams and drive results in a dynamic, fast-paced environment.

Demonstrated ability to thrive in a fast-paced, dynamic environment and adapt to changing priorities.

Preferred

Master's degree in Business Administration, Healthcare Administration, or related field.

Experience in start-ups or ability to move quickly despite insurance being a traditional industry.

Benefits

Medical, Dental, Vision, Life Insurance, HSA, Flexible Spending Accounts and 401(k)

Unlimited PTO - we encourage taking the time you need to relax and recharge

Wellness perks including monthly mental health days off (12 per year) in addition to holidays, and “No Meeting Wednesdays”

Up to $200 reimbursement for any equipment purchased to support your work-from-home environment (video camera, ring light, headset, etc.)

Access to free Cerebral therapy services (up to 7 sessions per year)

Medical travel expense health reimbursement arrangement

Paid parental leave after 3 months

Monthly peer-to-peer recognition allowance via Bonusly allows team members to reward one another for values-aligned contributions

Employee Resource Groups that bring team members together in a safe space to connect with one another and advance a respectful and inclusive company culture

Virtual social events enable us to build a sense of community and connect on a more personal level

Optional in-person local meetups for major hub cities