Vice President, Payer Relations

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🔴 Lead

👔 Vice President

👻 Ghost score 15%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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US Eye

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

👥 B2C

🤝 B2B

💰 Private equity on 2019-08

Healthcare • B2C • B2B

US Eye is a patient-first, physician-led, vertically integrated multi-specialty eye care practice focused on delivering premium clinical outcomes and an exceptional patient experience. The organization combines optometry, ophthalmology, and surgical services within an integrated management model, partners with independent practices to provide business, marketing, and operational support while preserving clinical autonomy, and operates multiple locations and clinical studies. US Eye emphasizes physician leadership, advanced technology, and coordinated care across its network.

📋 Description

• Develop and execute the organization’s payer-relations strategy across ophthalmology practices, ambulatory surgery centers, and affiliated services • Advise executive leadership on payer trends, reimbursement risks, contracting opportunities, and market developments • Lead negotiations for commercial, Medicare Advantage, managed Medicaid, and other payer agreements • Evaluate contract terms, reimbursement methodologies, fee schedules, payment policies, network requirements, and administrative provisions • Monitor contract terms, renewal dates, amendments, notice periods, and key obligations • Build and maintain relationships with payer executives, provider-relations representatives, contracting teams, and medical-management leaders • Serve as an escalation point for payer issues affecting reimbursement, patient access, claims processing, prior authorization, and provider participation • Monitor reimbursement trends, payer performance, denials, payment accuracy, and contract compliance • Analyze reimbursement by payer, service line, provider, location, and procedure category • Identify underpayments, payment variances, and systemic reimbursement issues • Evaluate network-participation opportunities and support payer enrollment and participation records • Collaborate with Revenue Cycle, Finance, Operations, Credentialing, Compliance, Legal, Clinical Leadership, and Information Technology teams • Support due diligence and integration planning for acquisitions and new market entry • Maintain awareness of healthcare reimbursement, managed-care, and regulatory developments • Lead, develop, and support payer-relations team members and assigned staff • Establish goals, performance measures, workflows, and accountability standards • Interview, hire, train, assign, direct, and appraise employees and address staff complaints and problems

🎯 Requirements

• Bachelor’s degree in healthcare administration, business administration, finance, economics, or a related field required • Eight or more years of progressive experience in payer relations, managed-care contracting, reimbursement strategy, healthcare finance, revenue cycle, or a related field • Demonstrated ability to interpret complex contract language, fee schedules, reimbursement methodologies, and payer policies • Advanced knowledge of payer contracting, managed-care principles, reimbursement structures, and healthcare financial analysis • Strong negotiation skills • Ability to evaluate complex data and translate findings into practical business recommendations • Strong executive presence and communication skills • Excellent judgment, analytical thinking, and problem-solving skills • Ability to manage multiple priorities, deadlines, and negotiations in a fast-paced healthcare environment • Strong written, verbal, and presentation skills • High level of professionalism, discretion, and integrity when handling confidential financial and contractual information • Proficiency with Microsoft Office applications and contract-management, reporting, and analytics tools • Travel is required • Ability to perform the stated physical demands, including walking, standing, bending, stooping, and lifting up to 10 pounds

🏖️ Benefits

• Full-time salaried position • Monday through Friday, 8:00 A.M.–5:00 P.M. • Reasonable accommodation may be given to individuals with disabilities