Senior Director, Payor Relations

This is a fully remote position, open to applicants in United States.

📋 Description

• Develop and oversee the execution of comprehensive Payor contracting and network management strategies at both regional and national levels.

• Propel the achievement of sales goals outlined in contracts while increasing market share and profitability.

• Spearhead the identification, development, negotiation, and oversight of Payor Relations agreements to ensure sustainable and competitive growth.

• Initiate and direct the rollout of innovative Payor relations programs and contracts, working in collaboration with senior internal stakeholders such as operations, finance, and Regional Vice Presidents.

• Supervise thorough financial analyses of Payor contracts to evaluate the earnings impact of new agreements, renewals, and significant network changes.

• Manage budget forecasts for pricing and assess the financial performance of Payor contracts.

• Ensure that Payors reimburse Soleo at the agreed-upon rates and that payments are made promptly.

• Optimize Soleo’s contracting strategy to maximize value by leveraging national contracts with chain codes instead of individually contracted pharmacies where applicable.

• Act as the primary executive liaison for major external partners, including hospitals, Payor organizations, and manufacturers.

• Cultivate and maintain strategic relationships to support business objectives.

• Oversee the design and implementation of advanced sales training programs focused on Payor relations, contract understanding, opportunities, and associated risks.

• Monitor and evaluate market trends and contractual activities to identify and capitalize on opportunities for new or expanded Payor agreements.

• Lead the creation of performance-based contracting models that reflect the latest advancements in the healthcare industry and align with organizational goals, such as Soleo’s participation in limited Payor networks.

• Maintain and revise the company's strategy in response to changes in healthcare legislation.

• Serve as a subject matter expert to guide policies and practices related to Payor Relations.

• Oversee the development and continuous updates of departmental policies to ensure compliance with regulatory, operational, and organizational standards.

• Collaborate with the Revenue Cycle Management team to protect Soleo’s interests during Payor audits.

• Complete all necessary managerial tasks for direct reports, including hiring, training, addressing performance issues, developing team objectives, conducting performance reviews, resolving conflicts, and strategic planning.

⛳️ Requirements

• Bachelor’s degree in a relevant field such as business administration, economics, or finance.

• At least 10 years of experience in Payor Relations and Contracting, including substantial leadership experience in complex healthcare environments.

• High school diploma (or equivalent) is required.

• Advanced degrees, such as an MBA or Juris Doctorate, are preferred.

• Strong communication, negotiation, and leadership abilities.

• Proven track record of leading high-performing teams and effectively managing senior-level projects and initiatives.

• Exceptional skill in analyzing complex data, identifying strategic insights, and utilizing them to enhance business performance and operational efficiency.

• Expertise in developing and presenting strategies and business plans to various stakeholders, including executive leadership, board members, and external partners.

• Operates effectively in a fast-paced, high-growth environment.

• Capable of managing multiple high-stakes projects simultaneously.

• 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, and vision insurance plans.

• Company-paid disability and basic life insurance.

• HSA and FSA options, including dependent care.

• Education assistance program.