Director, Pricing & Revenue

PDS Health•Irvine, CA

5d•$150,000 - $194,000

About The Position

Reporting to the VP, Insurance Products and Strategic Relations and managing a team of eight, the Dir, Plan Partnerships will lead the pricing strategy for multiple product and business lines as well as drive negotiations with a large portfolio of insurance companies. Success in this role will require executing with a revenue maximization mindset (vs. price maximization) and will extend PDS’ leadership position building the next phases of integrated oral healthcare. The incumbent will identify partnerships that redefine/strengthen the payer/provider relationship and create a participation model that supports integrated delivery of care within clinician’s licensure. Moreover, this position is responsible for the development of bundled and PDS branded plan recommendations focused on world class patient care, creating value for the Payer, and helping PDS achieve its revenue and margin targets.

Requirements

Master’s Degree with from an accredited college or university in Business Administration or related field, with a minimum of 10 years of related experience. In lieu of degree, 12+ years of experience is required.

Nice To Haves

Experience in a multi-regional healthcare, retail, or dental company.

Responsibilities

Align the product road map with corporate strategy, and work with Regional Operators, Professional Partnerships, and Payers to evolve and align the product and services value proposition in accordance with the growth strategy.
Identify areas where new products will meet the needs of emerging patient bases or the changing needs of existing PDS patients and dentists.
Gather feedback from leadership, sales, marketing, operators, and industry sources, and turn this feedback into data that can be used to evaluate opportunities.
Prepare product development documents for ideas that receive positive endorsements, for presentation at leadership meetings. Effectively communicate how the proposed products will contribute to growth and profitability in the market.
Work with senior management on developing market strategies and tactics in developing a strategic marketing plan for new and existing products/plans.
Responsible for conducting financial feasibility studies for new products as well as negotiating contracts with payers.
Drive specifications and timelines essential to growth and overall roll-out success.
Assess new markets and initiatives and analyze business opportunities.
Accountable for initiatives and programs; duties include negotiating contracts, initiating proposals, and closing deals with payers.
Conduct training sessions to explain all new products and product characteristics/changes.
Prepare materials for the market to explain new products and product changes.
Recommend to PDS’ affiliated dentists and practices which insurance carriers (dental, government, medical) and which level of plans (PPO, HMO, EPO, etc.) to partner with based on geographic regional differences.
Recommend the proper entry point of contact within the carriers to establish connection.
Oversee PDS’ relationship with carriers through participation on carrier boards/panels, participation in regulatory and governmental bodies and industry associations (e.g., CADP, ADP, etc.).
Negotiate fees, plan benefits, limitations, and exclusions for all lines of insurance with carrier partners on behalf of and for all PDS affiliated dental practices.
Educate PDS team members (affiliated clinical and operational) on existing carrier and plan negotiated benefits.
Keep updated on trends that may impact dental insurance and plans (e.g., potential impact of the Affordable Care Act; role of Accountable Care Organizations, etc.)
Perform other duties and responsibilities as requested or required.