Senior Director, Payor Relations

🕒 Julho 14

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Soleo Health

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

Fundada em 2013

🏥 Saúde

⚕️ Seguro de Saúde

💊 Farmacêutico

Healthcare • Healthcare Insurance • Pharmaceuticals

A Soleo Health é uma empresa de farmácia especializada que vai além do simples preenchimento de prescrições, proporcionando experiências personalizadas para pacientes e acesso a medicamentos especializados e terapias de infusão. Eles oferecem tratamento na casa dos pacientes, nos consultórios dos provedores ou em um dos muitos centros de infusão em todo o país. A Soleo Health é especializada no tratamento de doenças complexas e ultrarraras com foco na melhoria da qualidade de vida dos pacientes e na otimização dos resultados de saúde. Trabalham em estreita colaboração com pacientes, provedores, fabricantes farmacêuticos, pagadores e sistemas de saúde para fornecer terapias de alto custo, demonstrando valor através de dados de resultados no mundo real. A Soleo Health é reconhecida por sua excelência clínica e dedicação ao cuidado do paciente, e oferece serviços em todo o país, incluindo um portal online, Soleo Connect®, para comunicação em tempo real.

Descrição

• Formulate and oversee the implementation of comprehensive regional and national Payor contracting and network management strategies. • Drive the achievement of contracted sales goals and enhance market share and profitability. • Lead the identification, development, negotiation, and management of Payor Relations agreements to ensure competitive and sustainable growth. • Initiate and guide the launch of innovative Payor relations programs and contracts, collaborating with senior internal stakeholders including operations, finance, and Regional Vice Presidents. • Oversee detailed financial analyses of Payor contracts to assess the earnings impact of new contracts, as well as renewals and material network changes. • Manage budget projections for pricing and assess financial performance of payor contracts. • Ensure Payors are reimbursing Soleo at the contracted rates and that reimbursement is timely. • Enhance Soleo’s contracting strategy to maximize value (where applicable) using national contracts with chain codes vs. individually contracted pharmacies. • Serve as the primary executive contact for major external partners, including hospitals, Payor organizations, and manufacturers. • Build and maintain strategic relationships to bolster business objectives. • Oversee the design and implementation of advanced sales training programs that focus on Payor relations, contract comprehension, opportunities, and associated risks. • Monitor and analyze market trends and contractual activities to identify and seize opportunities for new or expanded Payor agreements. • Lead the development of performance-based contracting models that reflect the latest in healthcare industry advancements and match organizational goals (i.e., Soleo’s participation in limited payor networks). • Maintain and update the company's strategy in response to healthcare legislation changes. • Act as a subject matter expert to guide Payor Relations policies and practices. • Manage the creation and ongoing updates of departmental policies to ensure compliance with regulatory, operational, and organizational standards. • Partner with Revenue Cycle Management team to defend Soleo’s interests in payor audits. • Manage the creation and ongoing updates of departmental policies to ensure compliance with regulatory, operational, and organizational standards. • Completes all necessary managerial tasks for direct reports including hiring, training, addressing performance issues, developing team goals and objectives, performance reviews, conflict resolution, and strategic planning.

🎯 Requisitos

• Bachelor’s degree in a related field such as business administration, economics or finance • Minimum of 10 years in Payor Relations and Contracting • Significant leadership experience in complex healthcare environments. • High school diploma (or equivalent) required. • Advanced degrees such as an MBA or Juris Doctorate preferred. • Strong communication, negotiation, and leadership skills. • Proven track record of leading high-performing teams and effectively managing senior-level projects and initiatives. • Exceptional capability in analyzing complex data, identifying strategic insights, and employing them to improve business performance and operational efficiencies. • Expertise in developing and delivering strategies and business plans to a variety of stakeholders, including executive leadership, board members and external partners. • Operates effectively and successfully in fast-paced high growth environment. • Capable of managing multiple, high-stakes projects in parallel with one another. • Willingness and ability to travel extensively, often exceeding 50% of the time, to meet business needs.

🏖️ Benefícios

• Competitive Wages • 401(k) with a Match • Referral Bonus • Paid Time Off • Great Company Culture • No Weekends or Holidays • Paid Parental Leave Options • Affordable Medical, Dental, & Vision Insurance Plans • Company Paid Disability & Basic Life Insurance • HSA & FSA (including dependent care) Options • Education Assistance Program