Job description
VP of Payer Contracting
Full-Time: Mon – Fri
Location: 14100 San Pedro Ave.
San Antonio, Texas 78232
Reports to: Chief Financial Officer
Join us at Little Spurs! (Overview):
Little Spurs Pediatric Urgent Care and Little Spurs Autism Centers is looking to add a Vice President of Contracting to our growing team! The Head of Payor Contracting will be responsible for driving the contracting strategy and building health plan relationships for the Company. You will be responsible for supporting strategic partnerships with health plans, developing and nurturing relationships with key health plan stakeholders and managing all contract negotiations. This role will champion the development of value-based care strategies and initiatives to assess value-based payment models pertaining to the urgent care business, evolving healthcare payment reforms, and payment methodologies. The VP of Contracting will also require researching and mapping the feasibility and opportunity of new markets along with the rest of the team that is aligned with the Company’s strategic geographic expansion.
What You Need (Qualifications):
- Bachelor's Degree in Finance, Healthcare or related field required, advanced degree (MBA) a plus
- 6+ years negotiating commercial contracts with national and regional payors in TX including all major MCOs
- Ability to manage multiple projects, deadlines, and priorities in a fast-paced, ever-changing and evolving work environment
- Data analytics and population health management experience preferred
- 3+ years of people / team management experience
- Strong negotiation skills with a track record of results
- Excellent interpersonal, oral, and written communication skills, confident executive presence, and ability to communicate with and influence the Executive Leadership Team
- Strong negotiation and pricing strategy skills.
- Experience working with or within a health plan
- Health care provider contract operations, provider relations experience and/or health plan contracting experience
- Understanding of health plan network operations, billing, collections, and payor network management
- Adept at data analysis to inform contracting strategy
- Experience implementing and executing a strategic plan to support payor relations and business development activities
- Result-oriented with track record of achieving improved financial results through payor contracting
- Full COVID-19 vaccination is an essential requirement of this role.
The Perks (Benefits):
- Medical, Dental & Vision Benefits available employee, spouse, and dependents
- Voluntary Short-Term & Long-Term Disability & Voluntary Life Insurance (Employee, Spouse, Children).
- 401k with 4% company match on 5% employee contribution.
- Holiday pay (Closed Thanksgiving and Christmas); shorter holiday hours
- 80 hours of PTO accumulated through the year; available for rollover
- More PTO accrued after three and five years of service
- Free in-house medical care for employee and dependent children
- Employee recognition and appreciation programs
The Nitty Gritty (Your Day to Day):
- Lead payor relationship development and healthcare contracting activities with relevant regional and national payors
- Develop a consistent and effective payor contracting process, including collaboration and coordination with CEO / CFO.
- Establish a systematic approach to evaluating the financial viability of markets and partnership opportunities, in partnership with CFO and other key stakeholders
- Negotiate contracts on behalf of the Company, including fee for service, case rates and other value-based payment models
- Bring market knowledge and expertise, combined with data insights, to drive negotiation and contract strategy
- Support the Company Revenue Cycle Management team in working with payors as needed to resolve credentialling, claims submission, payment issues and processes
- Research geographic territories to identify gaps with our payor base and supporting the expansion into new markets
- Support business development functions to expand into new geographic markets, including researching and addressing any regulatory or payor requirements to support new business growth
- Perform other duties as assigned.
What Makes Us Tick (About Us):
Little Spurs Pediatric Urgent Care was founded in 2006 after we realized that most patients waiting in the Emergency Room for treatment are not there for life threatening emergencies, yet still need care that is not available in most pediatric offices. In 2022, Little Spurs Autism Centers was created after our sister company saw the increasing need for supportive, evidence-based ABA therapy among their patients. Together, Little Spurs Pediatric Urgent Care and Little Spurs Autism Centers are looking for team players looking to make a difference in their community and who want to grow with a company
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