Join VillageMD as SVP, Payor Relations & Contracting.
Join the frontlines of today's healthcare transformation
At VillageMD, we're looking for a SVP, Payor Relations & Contracting to help us transform the way primary care is delivered & how patients are served. As a national leader on the forefront of healthcare, we've partnered with many of today's best primary care physicians. We're equipping them with the latest digital tools. Empowering them with proven strategies & support. Inspiring them with better practices & consistent results.
We're creating care that's more accessible. Effective. Efficient. With solutions that are value-based, physician-driven & patient-centered. To accomplish this, we're looking for individuals who share our sense of excellence, are ready to embrace change, & never settle for the status quo. Individuals who have the confidence to lead but the humility to never stop learning.
Could this be you?
Integral to our team, the SVP of Payor Relations & Contracting will be accountable for creating a national strategy that defines our approach to payor partnerships across all markets & manages relationships with payors at a national level. This leader will be critical to driving successful payor partnerships through development & execution of agreements that support our business model, particularly our physician partners & patients served. This individual will be responsible for both leading & supporting payor negotiations with an emphasis on building strong, collaborative payor relationships that support innovative reimbursement structures to advance the best interest of high quality, affordable patient care.
How you can make a difference
- Provide strategic thought leadership to VMD, regarding value-based & fee-for-service contracting initiatives. These responsibilities need to be carried out with a high value placed on process buy-in, needs & reactions of constituencies, consensus, & expectation management.
- Lead all of the commercial & government contracting functions of the organization, & will be responsible for the continued developing of a portfolio contacting strategy that will support the growth the organization with a focus on value-based care
- Develop scalable team structure with regional leverage that manages local & state level health plan relationships
- Establish the department's strategic vision, objectives, & policies & procedures
- Lead the negotiation of complex, value-based payor agreements, & ownership over the strategic development & oversight of provider contracting
- Provide input to senior management & other enterprise-wide stakeholders relative to business development & strategic positioning as it relates to payer strategy
- Advise the executive team on emerging trends & methodologies in managed care contracting, payor relations & legal issues
- Pursue & develop relationships with payers & employers with regard to new payment models that support the strategic goals of the enterprise.
- Monitor relevant policy at a state & national level & assess opportunities & threats related to emerging & evolving issues
- Operate effectively in a highly integrated, matrix environment where s/he will regularly consult with colleagues & recommend plans of actions on a broad range of strategic & tactical initiatives.
- Apply current knowledge & understanding of regulations, industry trends, current best practices, new developments, & applicable laws to ensure operational & financial effectiveness. Partners to ensure regulatory compliance for all areas of responsibility
- Establish the department's vision, objectives, & policies & procedures
- Develop, implement, & maintain production & quality standards for the payor contracting department
- Partner with legal to obtain necessary TPA licenses in states where we are expanding delegation & risk services
- Develop & implement the contract structures & reimbursement methods & rates for all professional, institutional, ancillary & vendor providers
- Work closely with Operations team members to ensure that key provider support processes are optimize
- Negotiate & improve upon stop loss provisions & manage reinsurance program
- Improve deal terms for quality measures
- Partner & participate in business development efforts & initial outreach for expansion
- Form strong, collaborative, working relationships across multiple payor organizations to advance innovative reimbursement arrangements that support advancement of quality & affordability of care
Skills for success
- Ability to be proactive with strong personal initiative as well as highly organized & detail oriented
- Effectively contributing to building collaborative payor relationships that result in advantageous contract arrangements
- Understanding of medical cost trends that drive gains & losses across risk pools
- Ability to navigate within ambiguity, a service orientation, & a high level of humility are vital for successful assimilation into our highly collaborative, entrepreneurial culture
- Understanding of Medicare Advantage bid process
- Knowledge & understanding of health plan network operations preferred
Experience to drive change
- Demonstrated track record of building strong working relationships across operational leaders & potential payor partners
- Bachelors degree in Business required
- 10+ years in progressive roles required
- Demonstrated analytical, project management, & leadership skills
- Experience with & understanding of health care reimbursement methods,
- Experience modeling payor contracts
- Knowledge of value-based contract methodologies & preferred financial & administrative terms
- Experience negotiating quality & efficiency metrics preferred
- Ability to think independently, & develop new processes/analyses required
- Strong organizational skills with the ability to multi-task & execute against multiple competing priorities
- Proficiency in Excel, PowerPoint, & Word required
How you will thrive
In addition to competitive salaries, a 401k program with company match, bonus & a valuable health benefits package, VillageMD offers paid parental leave, pre-tax savings on commuter expenses, & generous paid time off. You work in a highly-collaborative, conscientious, forward-thinking environment that welcomes your experience & enables you to make a significant impact from Day 1.
Most importantly, you make a difference. You see a clear connection between your daily work on VillageMD products & services & the advancement of innovative solutions & improved quality of healthcare for providers & patients.
Our unique VillageMD culture how inclusion & diversity make the difference
At VillageMD, we see diversity & inclusion as a source of strength in transforming healthcare.We believe building trust & innovation are best achieved through diverse perspectives. To us, acceptance & respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system.Individuals seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
Those seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.
Explore your future with VillageMD today.