Regional Manager, Payor Relations

Concentra Career Choice•Newark, NJ

42d•Remote

About The Position

Concentra is recognized as the nation’s leading occupational health care company. With more than 40 years of experience, Concentra is dedicated to our mission to improve the health of America’s workforce, one patient at a time. With a wide range of services and proactive approaches to care, Concentra colleagues provide exceptional service to employers and exceptional care to their employees. The Regional Manager, Payor Relations develops, manages and maintains relationship to assigned payer accounts for a book of business with annual revenue up to and exceeding $50MM. Manages self as well as team’s implementation of regional sales and account management of current and future product offerings to assigned clients consisting of (and not limited to) the following: horizontal selling (growth), lead generation, developing and increasing direction of care, building brand awareness, service and issue resolution, implementing and executing uniquely defined mutual strategies, stewardship reporting, client consultation and overall customer satisfaction of all assigned accounts within the state or region.

Requirements

Bachelor’s degree in Business Administration, Marketing or related field from an accredited college, or combination of education and related-work experience and training.
In lieu of an undergraduate degree, the ratio is 1:1 meaning one year of college is equal to one year of directly related work experience and vice versa
Customarily has at least seven or more years of experience in healthcare, P&C Insurance, Worker's Compensation, and/or Managed Care
Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
Workers Compensation industry consisting of Carriers, Third Party Administrators, Managed Care
Organizations, Nurse Triage & Specialty Networks
Thorough insight into Key industry players and organizations
Working knowledge of Worker’s Compensation and clinical procedures/processes
Working knowledge of diagnoses and treatment of occupational injuries
Working knowledge of Medical Center and procedures
Experienced with allocation of resources
Subject matter proficiency in Economics & Accounting and Sales & Marketing
An awareness of Psychology to support the understanding of human behavior
Familiarity with applicable laws and government regulations to ensure compliance
Thorough understanding of strategic and conceptual selling or other formal sales training approach
Experienced in the use of CRM
Superior customer service mindset
Effective Communicator/Articulate
Strategic, Practical and Conceptual selling
Superior judgment and decision making
Systems evaluation
Critical thinking, analytical
High level of reading comprehension
Management of personnel resources
Results driven
Deadline orientation
High Energy
Oral comprehension and expression
Written comprehension and expression
Problem sensitivity

Responsibilities

Develop and manage self and the team’s successful relationships with assigned group of payor accounts, consisting of Insurance Carriers, Third Party Administrators, Managed Care/Managed Provider Networks, Professional Organizations, PBM, and Specialty Networks
Responsible for expanded knowledge of all of Concentra’s product offerings and the sales and execution of such, focusing on growing the clinic penetration and market share for zone exceeding assigned revenue growth for each assigned account
Implement Regional and Integrated Sales strategies and programs into the local market
Maintain productivity to meet and exceed the budgeted incremental revenue expectations
Conduct, lead and sponsor external presentations/stewardship/meetings/strategy meetings
Territory management which includes payor office visits and meeting with claims manager, supervisors, adjusters and nurse case managers
Participate in goal setting strategy sessions monthly and quarterly which are specific to mutual accounts between payer and division
Participate with internal teams to assist in the development of customer specific customer service protocol and strategies. Assist in improving services delivered at the Center/Centers.
Participate in continuing education programs on company products, services, sales training and industry compliance and assist with continuing education programs for client
Continually evaluate the need for needs assessments, sales call/product presentations, sales proposals and expansion, rate negotiation, providers and benefit comparisons, coordination of installation and implementation of services sold
Interface with internal departments to assist with developing and setting account strategy, managing contracting and price increases and understanding and controlling total profitability of assigned account(s)
Manage personal and Payor Director reporting through C4 activity
Maintain and submit to Vice President of Sales periodic outcome, pipeline forecasting, revenue performance (growth), statistical reports and issue resolution; Meeting or exceeding periodic growth goals and product expansion established with supervisor
Identify problems with assigned/unassigned payor/TPA/network accounts and facilitate timely solutions with specific company business unit. Serve as main contact between payer issues and division resolution
Develop payor sales lead efforts with zone and regional sales team and other zone disciplines in order to meet or exceed growth goals
Responsible for review and analysis of the financial performance of assigned territories to sales, area and zone management
Participate in and assists with coordination of payer audits by working with Central Billing Office (CBO) to ensure appropriate reimbursement for services rendered
Meet with regional leadership in various areas to review quality of care