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VP of Strategic Payor Relationships & Contracting

The Meadows

Job Description

This is where you change your story…

At Meadows we understand that new directions to career advancing and improvement can be scary, but we are excited to offer you a possible new rewarding chapter with us! Come join us in transforming lives!

Who are we?

We have been the most trusted name in the industry and have been helping people for 40 years. Our approach is different and success stories of our patients prove that. We don’t have one size fits all treatment and there are no quick fixes. 

Who are you?

Are you compassionate, innovative and have a passion to make an impact?  Are you looking to get your foot in the door with a company that will believe in your abilities and train you to advance? 75% of our current top-level executive staff are organic internal promotions from within. 

We are so excited to introduce this new role

This position will be a key employee that will drive and lead a new line of revenue for the business. We are a team of innovative out of the box thinkers that actively challenge our own paradigms each day. We are developing a new Virtual IOP department that need an entrepreneurial spirit to lead the managed care initiative. If this sounds like you, we want to talk to you!

Position Summary:

This role will lead development and execution of managed care contracts strategy which includes the negotiating, monitoring, and actualization of the agreements for the company. Executes on business development opportunities by focusing on the Meadows value proposition while penetrating the managed care market.

  • Negotiates managed care contract strategies including language, rates, and amendments, and monitors financial performance maximizing opportunities for net revenue improvement and volume/growth.   .
  • Owns and manages all aspects of assigned portfolio of managed care and associated payor relationships, including identifying opportunities to grow the company’s managed care business
  • Works collaboratively with key internal constituents to establish optimal Managed Care strategy, and ensure compliance and & successful implementation.
  • Monitors operational compliance of managed care contracts.
  • Develops and maintain effective business relationships with insurance company and key health system partners responsible for contracting with healthcare providers. 
  • Addresses fiscal integrity of contracts to minimize risk and maximize the company’s growth plan. 
  • Maintain current in-network contracts ensuring data requests from carriers is provided in a timely manner.
  • Facilitates meetings with the relevant payer contacts, creating tailored presentations / materials, seeking preparation and attendance support from appropriate internal colleagues, as necessary, and leading payor meetings
  • Oversee the process of health plan enrollment / credentialing applications for facilities and licensed providers with all government and commercial health plans.  Review weekly reports from credentialing database / tracking tools to ensure credentialing staff have prioritized the required follow-up with licensed providers and health plans and updated action notes to maintain accurate record of process with health plans.  Oversee the credentialing staff efforts to ensure all payor contracts are renewed prior to expiration. 
  • Works with Company’s billing office as needed when rates received by payors vary from the contract.  Discuss / resolve claim issues resulting from contract interpretation and / or language. 
  • Meet regularly with Business Office to discuss changes in payor policies affecting reimbursement or administration and any emerging payor concerns to incurring high-dollar losses.  Keep abreast of marketplace changes for payors, networks, reimbursement issues and changes in legislation or in guidelines at the State and Federal levels. 

Job Requirements

Education, Skills and Experience Requirements:

  • Bachelor’s Degree or equivalent combination of experience and education.
  • Three years’ experience negotiating and maintaining managed care contracts for a healthcare organization. Behvioral health setting preferred but not required.
  • Three years of leadership and building a high performing team

 

We are a Drug Free Company.  All positions are designated as “Safety Sensitive” positions and in light of our company mission, the Company does not employ medical marijuana cardholders. Following an offer of employment, and prior to reporting to work, all applicants will be required to submit to and pass a substance abuse screen.

The Meadows is an equal opportunity employer committed to diversity and inclusion in the workplace. Qualified candidates will receive consideration without regard to race, color, religion, sex, sexual orientation, age, national origin, disability, protected veteran status or any other factor protected by applicable federal, state or local laws. The Meadows provides reasonable accommodations to individuals with disabilities and if you need reasonable accommodation during any time of the employment process please reach out to [Click Here to Email Your Resumé]

#CB

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Job Snapshot

Location US-AZ-Phoenix
Employment Type Full-Time
Pay Type Year
Pay Rate N/A
Store Type Health Care

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Terms & Conditions
Snapshot
The Meadows
Company:
US-AZ-Phoenix
Location:
Full-Time
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
Health Care
Store Type:

Job Description

This is where you change your story…

At Meadows we understand that new directions to career advancing and improvement can be scary, but we are excited to offer you a possible new rewarding chapter with us! Come join us in transforming lives!

Who are we?

We have been the most trusted name in the industry and have been helping people for 40 years. Our approach is different and success stories of our patients prove that. We don’t have one size fits all treatment and there are no quick fixes. 

Who are you?

Are you compassionate, innovative and have a passion to make an impact?  Are you looking to get your foot in the door with a company that will believe in your abilities and train you to advance? 75% of our current top-level executive staff are organic internal promotions from within. 

We are so excited to introduce this new role

This position will be a key employee that will drive and lead a new line of revenue for the business. We are a team of innovative out of the box thinkers that actively challenge our own paradigms each day. We are developing a new Virtual IOP department that need an entrepreneurial spirit to lead the managed care initiative. If this sounds like you, we want to talk to you!

Position Summary:

This role will lead development and execution of managed care contracts strategy which includes the negotiating, monitoring, and actualization of the agreements for the company. Executes on business development opportunities by focusing on the Meadows value proposition while penetrating the managed care market.

  • Negotiates managed care contract strategies including language, rates, and amendments, and monitors financial performance maximizing opportunities for net revenue improvement and volume/growth.   .
  • Owns and manages all aspects of assigned portfolio of managed care and associated payor relationships, including identifying opportunities to grow the company’s managed care business
  • Works collaboratively with key internal constituents to establish optimal Managed Care strategy, and ensure compliance and & successful implementation.
  • Monitors operational compliance of managed care contracts.
  • Develops and maintain effective business relationships with insurance company and key health system partners responsible for contracting with healthcare providers. 
  • Addresses fiscal integrity of contracts to minimize risk and maximize the company’s growth plan. 
  • Maintain current in-network contracts ensuring data requests from carriers is provided in a timely manner.
  • Facilitates meetings with the relevant payer contacts, creating tailored presentations / materials, seeking preparation and attendance support from appropriate internal colleagues, as necessary, and leading payor meetings
  • Oversee the process of health plan enrollment / credentialing applications for facilities and licensed providers with all government and commercial health plans.  Review weekly reports from credentialing database / tracking tools to ensure credentialing staff have prioritized the required follow-up with licensed providers and health plans and updated action notes to maintain accurate record of process with health plans.  Oversee the credentialing staff efforts to ensure all payor contracts are renewed prior to expiration. 
  • Works with Company’s billing office as needed when rates received by payors vary from the contract.  Discuss / resolve claim issues resulting from contract interpretation and / or language. 
  • Meet regularly with Business Office to discuss changes in payor policies affecting reimbursement or administration and any emerging payor concerns to incurring high-dollar losses.  Keep abreast of marketplace changes for payors, networks, reimbursement issues and changes in legislation or in guidelines at the State and Federal levels. 

Job Requirements

Education, Skills and Experience Requirements:

  • Bachelor’s Degree or equivalent combination of experience and education.
  • Three years’ experience negotiating and maintaining managed care contracts for a healthcare organization. Behvioral health setting preferred but not required.
  • Three years of leadership and building a high performing team

 

We are a Drug Free Company.  All positions are designated as “Safety Sensitive” positions and in light of our company mission, the Company does not employ medical marijuana cardholders. Following an offer of employment, and prior to reporting to work, all applicants will be required to submit to and pass a substance abuse screen.

The Meadows is an equal opportunity employer committed to diversity and inclusion in the workplace. Qualified candidates will receive consideration without regard to race, color, religion, sex, sexual orientation, age, national origin, disability, protected veteran status or any other factor protected by applicable federal, state or local laws. The Meadows provides reasonable accommodations to individuals with disabilities and if you need reasonable accommodation during any time of the employment process please reach out to [Click Here to Email Your Resumé]

#CB

VP of Strategic Payor Relationships & Contracting Apply now