Payor Contracting & Partnerships Senior Analyst

Optima Dermatology•Portsmouth, NH

3d•Onsite

About The Position

Optima Dermatology is recruiting a Payor Contracting & Partnerships Senior Analyst to advance Optima’s commitment to make payor partnerships a strategic advantage for our practice. This full-time position is based out of our Portsmouth, NH corporate office. Our philosophical approach toward Payors at Optima is one of collaboration to bring our patients and our Payor partners’ members value, including our unique approach toward increasing access to the highest quality care and providing complex Mohs surgeries in an office setting that are typically done in a HOPD. We have built strong payor relationships by demonstrating the value we add through increased access to high quality dermatologic care in underserved areas and performing complex surgeries at a fraction of the cost of alternative settings. The shared goal between Payors and Optima of early detection and treatment affords better patient outcomes with less invasive procedures and can significantly reduce healthcare costs for both patients and Payors. In this role you will support all aspects of payor contracting, including analysis, developing and executing on a strategy for each deal, developing presentations for payor meetings, and owning all administrative and coordination functions associated with the department. Payor contracting analysis includes leading and executing on all analytics related to market position, pricing models and fee schedule analysis, and continuously enhancing Optima’s processes and analytics for payor contracting. Two other key elements of the role are 1) Managing all communications with payors and 2) developing thoughtful presentations for all meetings with payors which are designed to advance our negotiations. A successful team member in this role will be results oriented and driven to build long-term relationship with payors. Effective results are measured by the outcome of a contract renewal.

Requirements

Expertise in producing detailed analyses, modeling, collecting data; with the ability to design and produce data models
Experience leading or supporting complex negotiations
Strategic in ability to develop, quantify, explain, and present valuable ideas to advance a negotiation
Highly proficient in developing and preparing PPT presentations
Excellent communication skills both verbal and written that translate to presentations, white papers, letters, and email correspondence with an eye toward moving a negotiation forward to a desired outcome.
Highly organized and detail oriented, with strong ability to manage to multiple deadlines and closing the loop with key stakeholders
Results and outcomes oriented
Strong work ethic and highly motivated; will get the job done, self-starter, energized by fast paced environment.
Technologically savvy with the aptitude to learn new systems and processes that drive efficiencies. Examples include Salesforce (CRM), Asana (project management), Modernizing Medicine (practice management), Microsoft Office, including Excel (modeling), navigating SharePoint and other file management applications.
Articulate, present well, compelling presence
Must be solution oriented.
2+ years of experience in an external facing role with strong interpersonal skills and proven ability to establish a rapport with external stakeholders
Proven experience in payor contracting, either direct contracting or a supporting role required. Payor Network Management experience preferred
Experience developing strategies with subsequent presentations and proposals
Strong project lead/management skills
This is a demanding role that requires strong ownership, initiative, and the ability to perform effectively in a fast-paced environment. Successful candidates are comfortable working independently, navigating imperfect data and systems, and taking responsibility for driving work forward.
The role requires the ability to learn quickly, adapt to evolving priorities, and deliver thoughtful, high-quality work under tight timelines.
Candidates should be prepared to invest significant time and effort to learn the role, develop analyses, presentations, and negotiation strategies that support successful outcomes.
During onboarding and training, candidates will be expected to ramp up quickly and demonstrate steady progress toward proficiency in the role.

Nice To Haves

Payor Network Management experience preferred

Responsibilities

Model Payor position in each market, accounting for revenue, utilization, provider type, and lines of business, and product differentials through thoughtful navigation of challenging or fragmented data environments.
Produce white papers to thoughtfully present payor relativity and provider relativity clearly targeted for to your intended audience.
Continuous analysis of data to generate useful and compelling insights that can inform negotiations and may be presented to payors to advance our position
Develop and continuously improve Optima’s value proposition presentation materials for all Payor related discussion, both internal and external.
Produce PPT presentations in advance of all meetings with payors; all presentations should present a clear and compelling narrative.
Map out a clear negotiation strategy for each deal in advance of discussions with Payors.
Maintain schedule and develop ideas for periodic outreach with practice updates, especially during non-negotiation periods.
Review and negotiate contracts through to signature (including managing Optima leadership review and approval), particularly for any terminations or contract extensions.
Maintain detailed notes of all communications with Payors, particularly contact details, communications (calls and emails), updated strategies on how to achieve goals, and planned next steps in our CRM (Salesforce) and in a Word document.
Utilize Asana for project management and prioritization of deals, goals, request intake and prioritization, and other action items and assignments to individuals on the Optima team.
Maintain detailed tracking of all Payor contract renewals and notices, and deal terms and update any time a deal is completed. Review on a weekly basis with Optima leadership.
Track and report on department KPIs tracked at regular cadences.
Maintain contracts and fee schedules for all Payors.
Plan deals for the next twenty-four (24) months and develop target outcomes for each deal.
Review chargemasters following the completion of deal negotiations, and not less than every six (6) months to ensure charges are never less than highest contracted rate.