Job Description:
• Formulate and oversee the implementation of comprehensive regional and national Payor contracting and network management strategies.
• Drive the achievement of contracted sales goals and enhance market share and profitability.
• Lead the identification, development, negotiation, and management of Payor Relations agreements to ensure competitive and sustainable growth.
• Initiate and guide the launch of innovative Payor relations programs and contracts, collaborating with senior internal stakeholders including operations, finance, and Regional Vice Presidents.
• Oversee detailed financial analyses of Payor contracts to assess the earnings impact of new contracts, as well as renewals and material network changes.
• Manage budget projections for pricing and assess financial performance of payor contracts.
• Ensure Payors are reimbursing Soleo at the contracted rates and that reimbursement is timely.
• Enhance Soleo’s contracting strategy to maximize value (where applicable) using national contracts with chain codes vs. individually contracted pharmacies.
• Serve as the primary executive contact for major external partners, including hospitals, Payor organizations, and manufacturers.
• Build and maintain strategic relationships to bolster business objectives.
• Oversee the design and implementation of advanced sales training programs that focus on Payor relations, contract comprehension, opportunities, and associated risks.
• Monitor and analyze market trends and contractual activities to identify and seize opportunities for new or expanded Payor agreements.
• Lead the development of performance-based contracting models that reflect the latest in healthcare industry advancements and match organizational goals (i.e., Soleo’s participation in limited payor networks).
• Maintain and update the company's strategy in response to healthcare legislation changes.
• Act as a subject matter expert to guide Payor Relations policies and practices.
• Manage the creation and ongoing updates of departmental policies to ensure compliance with regulatory, operational, and organizational standards.
• Partner with Revenue Cycle Management team to defend Soleo’s interests in payor audits.
• Manage the creation and ongoing updates of departmental policies to ensure compliance with regulatory, operational, and organizational standards.
• Completes all necessary managerial tasks for direct reports including hiring, training, addressing performance issues, developing team goals and objectives, performance reviews, conflict resolution, and strategic planning.
Requirements:
• Bachelor’s degree in a related field such as business administration, economics or finance
• Minimum of 10 years in Payor Relations and Contracting
• Significant leadership experience in complex healthcare environments.
• High school diploma (or equivalent) required.
• Advanced degrees such as an MBA or Juris Doctorate preferred.
• Strong communication, negotiation, and leadership skills.
• Proven track record of leading high-performing teams and effectively managing senior-level projects and initiatives.
• Exceptional capability in analyzing complex data, identifying strategic insights, and employing them to improve business performance and operational efficiencies.
• Expertise in developing and delivering strategies and business plans to a variety of stakeholders, including executive leadership, board members and external partners.
• Operates effectively and successfully in fast-paced high growth environment.
• Capable of managing multiple, high-stakes projects in parallel with one another.
• Willingness and ability to travel extensively, often exceeding 50% of the time, to meet business needs.
Benefits:
• Competitive Wages
• 401(k) with a Match
• Referral Bonus
• Paid Time Off
• Great Company Culture
• No Weekends or Holidays
• Paid Parental Leave Options
• Affordable Medical, Dental, & Vision Insurance Plans
• Company Paid Disability & Basic Life Insurance
• HSA & FSA (including dependent care) Options
• Education Assistance Program