POSITION SUMMARY

The Vice President of Managed Care--Contracting and Payor Solutions will optimize Physicians Immediate Care’s (PIC) contract performance with its key payors so as to advance PIC’s fee-for-service reimbursement and value-based care strategy - a blend of increasing access to covered lives across payors, unit price reimbursement increases, value-based contracts, expansion of PIC's attributed lives, and delivering overall value to payors and patients while achieving strong financial performance for PIC.

ESSENTIAL FUNCTIONS

Responsibilities include:

• Leads the development and implementation of PIC’s Managed Care Contracting strategy and implementation, including operations management of the managed care and credentialing staff
• Serves as PIC’s chief contracting officer and lead negotiator with external payors (e.g., national/regional insurance carriers)
• Contributes to strategy development and negotiations with self-funded employer groups in support of PIC’s direct-to-employer relationships focused upon driving urgent care visits to PIC
• Reviews current contracts to determine opportunities to expand/renew and improve reimbursement through further sharing of data and articulating PIC’s distinctive competence
• Assures all contracts and processes comply with corporate policies and standards
• Maintains compliance with all relevant agency policies and procedures
• Coordinates internal and external communications regarding payor issues and negotiations
• Staff and operating budget management responsibility for all functional departments: Contracting and Credentialing
• Develops and maintains good working relationships with leadership across the organization and outside the organization (e.g., payor relationships, other industry leaders, etc.)
• Participates in professional activities and maintains professional affiliations as appropriate
• Other duties as assigned

Required Skills

QUALIFICATIONS

Bachelor's degree in Sales, Marketing, Business, or a health related science (e.g., nursing, pharmacy, etc.) or the equivalent

Minimum of ten years health care and related industry experience including three years in a supervisory role

• Payor and provider experience required

Thorough knowledge of sales/marketing techniques and the ability to engage managed care organizations at all levels

Hands-on leader who offers a solid track record of excellent performance

Proven ability to think conceptually and to develop and implement strategic organizational goals, working with leaders within and outside of PIC and our health system partners

Very detail-oriented and analytical with the ability to conceptualize, analyze and present the cost and clinical data to prove PIC’s value proposition to payors

A demonstrated track record in negotiation of payor and/or provider contracts, with outstanding people-relations skills and demonstrated results

Must have high intelligence, integrity and common sense

Demonstrated ability to think strategically coupled with strong attention to detail

Strong communication and presentation skills, coupled with the ability to collaborate with leaders across the Company

Strong influencing skills to manage team members and positively interact with physicians and advanced practice providers

Strong ability to manage, change and improve organizational effectiveness so as to achieve targeted results

Required Experience

QUALIFICATIONS

Bachelor's degree in Sales, Marketing, Business, or a health related science (e.g., nursing, pharmacy, etc.) or the equivalent

Minimum of ten years health care and related industry experience including three years in a supervisory role

• Payor and provider experience required

Thorough knowledge of sales/marketing techniques and the ability to engage managed care organizations at all levels

Hands-on leader who offers a solid track record of excellent performance

Proven ability to think conceptually and to develop and implement strategic organizational goals, working with leaders within and outside of PIC and our health system partners

Very detail-oriented and analytical with the ability to conceptualize, analyze and present the cost and clinical data to prove PIC’s value proposition to payors

A demonstrated track record in negotiation of payor and/or provider contracts, with outstanding people-relations skills and demonstrated results

Must have high intelligence, integrity and common sense

Demonstrated ability to think strategically coupled with strong attention to detail

Strong communication and presentation skills, coupled with the ability to collaborate with leaders across the Company

Strong influencing skills to manage team members and positively interact with physicians and advanced practice providers

Strong ability to manage, change and improve organizational effectiveness so as to achieve targeted results