Vice President, Payor Contracting

Healthcare Outcomes Performance Co. (HOPCo)•Phoenix, AZ

18h

About The Position

The Vice President, Payor Contracting serves as the contracting liaison between contracted payors and providers and develops effective relationships with internal and external customers. The role leads payor contract analysis and negotiations on providers’ behalf, covering rates, payment methodologies, contract language, and value-based payment programs, while following internal contract review, approval, and signature controls. The position leads the development of maintainable payor reimbursement analyses to support reimbursement strategies and payment integrity. It researches contracting opportunities in new and existing geographic service areas and makes recommendations to executive leadership. The role also ensures compliance in business and contractual relationships, communicates trends and potential issues to market leadership and the HOPCo management team, and develops infrastructure and analyses for strategic projects such as rate transparency, payment validation, Revenue Cycle Management coordination, and payor contracting strategy, including a value-based care glidepath. Other duties may be assigned. The position works in a normal office environment or remotely, with some travel within the community. It involves the sitting and standing associated with an office environment, some bending and stretching, and manual dexterity when using a calculator and computer keyboard. The job holder must acknowledge and adhere to HOPCo’s Mission, Vision, and Values, and comply with OSHA requirements and safety training.

Requirements

Bachelor’s degree in Business, Mathematics, Finance, or Healthcare Administration.
Proven working knowledge of provider financial issues, complex contracting options, financial and contracting arrangements, and regulatory requirements.
7–10 years of related experience, with comprehensive analytical and negotiating skills and a successful track record supporting payor contract negotiations.
Strong communication, critical-thinking, problem-resolution, and interpersonal skills.
Solid understanding of industry dynamics.
Familiarity with managed care products and services and medical cost trend analysis, including analysis of physician contracts, utilization, and costs.
Prior experience working with managed care contracting modeling.
Familiarity with concepts, practices, and procedures in managed care.
Ability to solve problems and make recommendations.
Ability to stay on task with minimal supervision.
Excellent critical-thinking, troubleshooting, and analytical skills.
Knowledge of payor reimbursement, managed care contracting, and the market and industry.
Strong verbal and written communication skills.
Strong organizational skills and careful attention to detail.
Advanced computer skills.
Ability to analyze problems and interpret information.
Ability to prioritize and reprioritize as necessary.
Ability to work independently and as part of a team.
Ability to multitask, manage multiple projects, and meet tight deadlines.

Responsibilities

Develop and maintain positive, effective relationships with internal and external customers.
Serve as the contracting liaison between contracted payors and providers.
Lead contract analysis and payor negotiations on behalf of providers, including rates, payment methodologies, contract language, and value-based payment programs, in accordance with internal review, approval, and signature processes.
Lead development of routinely updatable payor reimbursement analyses to establish a baseline for reimbursement strategies and payment integrity.
Research and recommend payor contracting opportunities in new and existing geographic service areas to executive leadership.
Ensure compliance in business and contractual relationships.
Identify and communicate trends and potential issues to market leadership and the HOPCo management team.
Lead development of infrastructure and analysis for strategic projects, including rate transparency, payment validation, coordination with Revenue Cycle Management, and payor contracting strategy including a value-based care glidepath.
Perform other duties and responsibilities as assigned.
Acknowledge and adhere to HOPCo’s Mission, Vision, and Values, and comply with OSHA requirements and safety training.