Senior Manager, Payer Implementation

🕒 Novembro 3

🏛️ District of Columbia, New York, +2 estados a mais – Remoto

🏛️ District of Columbia – Remote 🗽 New York – Remote 🍂 Massachusetts – Remote 🎸 Tennessee – Remote

⏰ Tempo Integral

🟠 Sênior

👔 Gerente

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O que significa: a chance de ninguém estar realmente contratando para esta vaga.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Por que essa pontuação:

• Aberta há 7 dias.
• As vagas desta empresa costumam ser preenchidas em 37 dias.
• 7 vagas abertas para uma equipe de 12 pessoas.
• Sem salário divulgado.

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Chamber

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1 - 10 funcionários

🏥 Saúde

⚕️ Seguro de Saúde

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

A Chamber é uma empresa focada em melhorar a saúde cardiovascular, capacitando equipes de cardiologia a prosperarem em um ambiente de cuidados baseados em valor. Ela faz parcerias com cardiologistas para oferecer soluções tecnológicas e serviços de suporte que possibilitam um atendimento abrangente e desbloqueiam novas oportunidades de receita, sem custo para a prática. A Chamber auxilia na navegação dos cuidados baseados em valor por meio de insights em tempo real, suporte administrativo e expertise em negociações com pagadores. Com uma forte rede de cardiologistas de alto desempenho e parcerias com sistemas hospitalares, a Chamber está transformando o ecossistema de cuidados em cardiologia para garantir que os provedores sejam compensados por oferecer o atendimento certo na hora certa.

Descrição

• Own day-to-day payer implementation delivery from late-stage contract conversations through go-live • Build and maintain project plans, coordinate supporting workstreams, and drive open items to resolution • Assess implementations already underway, identify unresolved issues, and drive decisions needed to move forward • Establish and lead payer implementation workstreams • Own data exchange requirements, file layouts, test files, acceptance criteria, and pre-go-live validation • Track enrollment, eligibility, in-program, and exclusion rules and ensure written definitions are aligned • Run clinical design sessions, pre-reads, follow-ups, and decision logs • Coordinate outreach and marketing approvals, consent and opt-out handling, and outreach timing • Coordinate BAAs, data use agreements, and other payer contracts with Legal • Coordinate payer vendor onboarding and compliance activities, including security questionnaires, delegation assessments, training attestations, exclusion screening, and oversight audits • Run launch readiness reviews and go/no-go decisions, lead post-launch stabilization, and deliver handoff to account management • Serve as Chamber’s implementation point of contact with payer partners, guiding meetings and ensuring follow-through • Surface risks and decisions, escalate blockers, and protect launch timelines • Prepare project plans, presentation decks, meeting notes, decision logs, progress reports, and implementation updates • Partner with Clinical, Operations, Finance, Provider Operations, Legal, and other cross-functional teams • Own and expand Chamber’s payer implementation playbook and toolkit • Run lessons-learned reviews after launches and incorporate improvements into the playbook

🎯 Requisitos

• 5+ years of experience leading payer implementations, as a vendor to health plans or inside a plan onboarding vendors, including getting data, compliance, legal, marketing, and clinical teams at the payer aligned and moving on the same timeline • Experience building and leading a payer implementation plan when scope and requirements were not fully defined • Comfort with ambiguity and operating where standard structure and processes might not exist yet • Experience managing several workstreams at once, including data, outreach, and clinical operations • Strong written communication and documentation skills, including creating clear, accurate payer-facing presentations, meeting summaries, and implementation materials • Experience managing cross-functional partnerships through influence rather than direct authority • Candidates must be authorized to work in the United States without sponsorship • Value-based care experience, health plan vendor oversight or delegation requirements, ideally for Medicare Advantage, is a plus

🏖️ Benefícios

• Remote opportunity, based in the United States • Occasional travel to client sites

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