Contracting and Payor Relations Director
The Contracting and Payor Relations Director of contracting and payor relations is directly responsible for developing, implementing, and leading a strategic approach to building and sustaining a robust payor network across all lines of DME contacting including government and private payors. The Director is accountable to research, contract administration, recommending payor strategy and new contracting to enhance revenue to support the organization’s overall growth strategy.
This role will lead negotiation, implementation via cross functional internal relationships, maintenance of the contract performance, recredentialing and payor relations. This position will be responsible for developing new and existing relationships with payors to ensure competitive and profitable reimbursement rates and contract language that patient services and revenue cycle operations is able to uphold without enhanced labor-intensive needs. The director will be the internal liaison for negotiating eligibility protocols, referrals, enrollment, billing issues, and employee education that relate to contracting. The Director will be comfortable with communication to payors on denial trends, and compliance with contract parameters.
Responsibilities (Specific tasks, duties, essential functions of the job)
- Develop and lead the execution of national and regional contracting initiatives, including identifying top contracting opportunities, negotiations and payor relations functions including commercial and government payors.
- Responsible for oversight of the company’s Medicare competitive bidding contracts submission, compliance, and reporting.
- Interface with executive leadership and business subject matter experts on the development and execution of complex payor/network contracting strategy.
- Adopt a data driven approach to developing payor contracting strategies and contracting terms.
- Conduct regular status updates with executive teams and provide management with a clear sense of progress and understanding of any industry landscape and marketplace changes (major insurance, network and reimbursement issues, changes in legislation or in guidelines at the federal levels).
- Collaborate with internal department leaders to review contract performance and compliance.
- Act as liaison between payor contracting, compliance, patient intake, order intake, physician and patient sales teams, and revenue cycle.
- Effectively manage contract deadlines and renewals, including recredentialing requirements.
- Communicate with relevant stakeholders to ensure contract commitments are operationalized.
- Lead the development of tools to model contracts and monitor payor performance.
- Identify and implement best practices in payor contracting and contract management in a manner that forges a culture of compliance and regulatory best standards.
- Maintain regular and punctual attendance.
- Comply with all company policies and procedures.
- Assist with any other duties as assigned.
Knowledge, Skills, and Abilities
- Demonstrate critical thinking, problem solving, decision making, sound judgement and assertiveness as needed.
- Strong relationship building and interpersonal skills in working with internal and external customers.
- Ability to work self-manage and work independently.
- Ability to thrive in a dynamically changing organization.
- Excellent management skills, both of individuals as well as projects.
- Excellent oral and written communication skills required and ability to tailor those to the audience across front line reps all the way to an executive level audience.
- Proficiency in analyzing, understanding, and communicating reimbursement and financial trends that impact organization economics (example: denials, rate changes)
- Demonstrated and verifiable, presentation, negotiation and relationship-building skills and ability to engage at all levels of an organization
- Ability to manage multiple priorities in a fast-paced environment and exercise independent judgement in contract negotiations
- Attention to detail is required.
- Effective conflict resolution skills.
- Excellent planning and organizational skills.
- Ability to effectively interface with different departments within the company.
- Ability to articulate and promote data driven decision making.
- Travel required: up to 50% domestically
Qualifications (Experience and Education)
- Bachelor’s degree in Business, Health Care Management or related field, required.
- MS/MBA/MA, preferred.
- 12-15 years’ of combined experience in the following areas: DME / HME contracting, network development, payor relations, healthcare marketplace/management, health plan contracting and reimbursement service operations, required. 2 years’ experience at a Director level or above, preferred.
- 6 years’ management experience, with a minimum of five direct reports, required.
- Advance knowledge/proficiency in government (Medicare/Medicaid) and Commercial Insurance Contracting and negotiating DME/HME/Competitive Bid Contracts, required.
- Advance knowledge/proficiency in Microsoft office tools (Excel, Access, PowerPoint), required.
- A combination of training, education and experience that is equivalent to the qualifications listed above and that provides the required knowledge, skills, and abilities
We thank all applicants in advance for their interest in the position. However, only those selected for an interview will be contacted.
Inogen is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally
protected characteristics. The EEO is the Law poster and its supplement are available here: http://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm;
The pay transparency policy is available here: http://www.dol.gov/ofccp/pdf/EO13665_PrescribedNondiscriminationPostingLanguage_JRFQA508c.pdf.
Inogen is committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation because of a disability for any part of the employment process, please send an e-mail to firstname.lastname@example.org or call (972) 616-5668 and let us know the nature of your request and your contact information.
- Job Function Management
- Pay Type Salary
- Required Education Bachelor’s Degree
- Inogen, Inc., 600 Shiloh Road, Plano, Texas, United States of America