Senior Director, Payor Relations

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

📋 Description

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

• Propel the attainment of contracted sales targets while increasing market share and profitability.

• Lead the identification, development, negotiation, and management of Payor Relations agreements to foster competitive and sustainable growth.

• Initiate and manage the launch of innovative Payor relations programs and contracts, collaborating with senior internal stakeholders, including operations, finance, and Regional Vice Presidents.

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

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

• Ensure that Payors reimburse Soleo at the contracted rates and that payments are processed in a timely manner.

• Enhance Soleo's contracting strategy to maximize value (where applicable) by utilizing national contracts with chain codes instead of individually contracted pharmacies.

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

• Cultivate and sustain strategic relationships to support business objectives.

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

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

• Spearhead the development of performance-based contracting models that align with the latest advancements in the healthcare industry and meet organizational goals (e.g., 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 inform Payor Relations policies and practices.

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

• Collaborate with the Revenue Cycle Management team to advocate for Soleo's interests during Payor audits.

• Complete all essential managerial duties for direct reports, including hiring, training, addressing performance issues, developing team goals and objectives, conducting performance reviews, conflict resolution, and strategic planning.

⛳️ Requirements

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

• A minimum of 10 years of experience in Payor Relations and Contracting, including substantial leadership experience in complex healthcare settings.

• 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 history of leading high-performing teams and effectively managing senior-level projects and initiatives.

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

• Expertise in formulating and delivering strategies and business plans to diverse stakeholders, including executive leadership, board members, and external partners.

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

• Capable of managing multiple high-stakes projects concurrently.

• Willingness and ability to travel extensively, often exceeding 50% of the time, to fulfill 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