Senior Payor Strategy Specialist

JOB OVERVIEW:

The Senior Payor Strategy Specialist  is responsible for driving the expansion and sustainability of our strategic payor footprint across assigned geography and/or accounts: Medicare, Medicaid, Commercial, Military, Managed Care Organizations (MCOs), Accountable Care Organizations (ACOs) and more. 

Target Pay Range: $90,000-$105,000 - Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data. 

Benefits: 

• Discretionary PTO + 8.5 days of additional sick time + 10 paid holidays
• Paid parental leave
• 100% Employer Paid Medical, Dental, and Vision Insurance
• Employer Paid STD & LTD
• 401k
• $50 monthly Remote Work Stipend

RESPONSIBILITIES:

• Formulate and execute comprehensive payor strategies and business plans to drive departmental sales goals.
• End-to-end lifecycle - initiating, negotiating, renegotiating and executing complex  payout contracts, letters of agreement and contract revisions, as prioritized by claims volume, market trends and/or corporate leadership.
• Establish, scale and nurture regional and strategic account relationships at multiple levels with the partner. 
• Maintain a strong focus on helping the market understand Bicycle Health’s unique value proposition. 
• Utilize  financial modeling to assess the sustainability of Payors rate structure and/or proposed rates for new accounts or account rate changes. 
• Contract with new partners and negotiate sustainable rate schedules implementing bundled or value-based pricing strategies whenever possible. 
• Ensure contract language is consistent with Bicycle Health’s interests.
• Implement Payor Contracts to maximize potential revenue and pull through opportunities. 
• Expand upon existing relationships to increase the value of the account by renegotiating rates, introducing value-based models, and/or expanding go-to-market efforts.
• Complete all designated profiles and documentation on new deals to be reviewed.
• Document progress in sales support applications and communicate consistently regarding sales forecasting. 
• Become a subject matter expert regarding payor contract implementation and strategic account management for assigned accounts. 
• Partner with the internal team included Revenue Cycle Management, Licensing and Credentialing, Compliance, Marketing, Operations, Enrollment and all other stakeholders to ensure contract alignment and execution. 
• Regular and predictable attendance is expected.
• All other duties as assigned.

QUALIFICATIONS:

• Bachelor’s degree preferred
• 5+ years of business development experience in the payor sector. Value-based care experience is a plus.
• Existing relationships with, and experience selling value-based products/services to Regional Payors.
• Ability to review contracts, respond with readiness, and negotiate win-win deals with Payors.
• Prior experience working with Revenue Cycle Management teams and contract implementation.
• Strong communicator who can proactively identify potential challenges and think creatively about solutions.
• Team player that is highly collaborative, goal-oriented, and confident.
• Ability to receive feedback and take constructive steps to improve skill sets as needed in a fluid and changing environment. 
• Self-starter who thrives when given autonomy but able to escalate as appropriate and is comfortable with ambiguity.
• Skilled at documentation and familiar with use of a CRM, attention to details.
• Able to manage multiple tasks simultaneously and effectively.   
• Possesses prioritization skills to meet long-term and short -term goals
• Consistent access to a private work environment with high speed internet and professionally appropriate surroundings for frequent video conferencing and a workstation setup conducive to remote work needs.

This is a full-time (40hrs per week) remote position.

#LIRemote #zr Mid-Senior Level -