Director, Payor Contracting – Population Health

🔥 13 hours ago

🏄 California, Colorado, +3 more states – Remote

🏄 California – Remote ⛰️ Colorado – Remote 🔔 Pennsylvania – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote

💵 $94.5k - $148.1k / year

⏰ Full Time

🔴 Lead

👔 Director

👻 Ghost score 0%

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Cencora

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

🏥 Healthcare

Consulting • Logistics • Healthcare

Cencora is a company dedicated to improving the health and well-being of both people and animals globally. Built on the legacy of AmerisourceBergen, Cencora offers a wide range of industry-leading solutions that encompass specialty logistics, warehousing, drug research, clinical development support, and more. They provide commercialization and patient access support and offer wholesale and specialty distribution services. Cencora serves a diverse clientele, including pharmaceutical companies, physician practices, pharmacies, and health systems. The company also extends its services to animal health, managing operations and delivering products for animal pharmaceutical care. With a strong global footprint, Cencora aims to reshape healthcare delivery through innovative products and solutions, striving to create healthier futures for all.

📋 Description

• Lead managed care negotiations and payor relationship maintenance, including reimbursement rates, administrative requirements, language, and terms • Serve as the primary liaison with payors for contracting escalations, disputes, innovative business relationships, and direct engagements • Assess macro trends and market-specific nuances to identify opportunities by market and payor • Develop pitches to achieve goals for rates, prior authorization pass/gold-carding, and population health incentives • Review health plan agreements and fee schedules of acquisition targets • Craft integration strategies to optimize stakeholder value • Represent Retina Consultants of America and regional teams in national managed care and intermediary negotiations • Maintain the contract management platform with agreements and fee schedules • Partner with Financial Planning and Analytics to verify financial impacts and develop budgets • Monitor and report market trends, relative pricing, health plan trends, and revenue enhancement opportunities • Develop and implement solutions for underperforming program contracts, including denials and underpayments improvements • Prepare reporting and analytics to support recommendations for internal and external use

🎯 Requirements

• Bachelor’s Degree in accounting, finance, or business administration • 5+ years of contracting, negotiations, and health plan portfolio management experience in specialty medicine, private equity, or health care contracting • Deep experience understanding the healthcare field, including payer-provider relationships, analytics, and aligning incentives • Experience in a high-growth, fast-paced, high-pressure, constantly changing environment • Strong analytical skills and attention to detail, accuracy, and accountability • Ability to own health plan relationships for negotiations • Ability to leverage data, insights, and communication strategies to influence stakeholders and achieve business objectives • Strong detail orientation and ability to prioritize data in decision-making • Ability to build constructive relationships • Ability to manage collaborative, matrix relationships across the organization • Strong interpersonal skills for collaboration with cross-functional teams and executives • Excellent professional written and verbal communication skills and executive presence • Ability to work hands-on with urgency and deliver excellent work in a fast-paced, rapidly growing company

🏖️ Benefits

• Medical, dental, and vision care • Backup dependent care • Adoption assistance • Infertility coverage • Family building support • Behavioral health solutions • Paid parental leave • Paid caregiver leave • Training programs • Professional development resources • Mentorship programs • Employee resource groups • Volunteer activities • Reasonable accommodations during the employment process