Senior Payor Strategy Specialist

Job Overview

The Senior Payor Strategy Specialist is responsible for driving the expansion and sustainability of our strategic payor footprint across assigned geography and/or accounts: Medicare, Medicaid, Commercial, Military, Managed Care Organizations (MCOs), Accountable Care Organizations (ACOs) and more.

Target Pay Range: $85,000-$105,000 - Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Benefits

• 3 Weeks PTO + 8.5 days of additional sick time + 10 paid holidays
• Paid parental leave
• 100% Employer Paid Medical, Dental, and Vision Insurance
• Employer Paid STD & LTD
• 401k
• $50 monthly Remote Work Stipend

Responsibilities

• Formulate and execute comprehensive payor strategies and business plans to drive departmental sales goals.
• End-to-end lifecycle - initiating, negotiating, renegotiating and executing complex payout contracts, letters of agreement and contract revisions, as prioritized by claims volume, market trends and/or corporate leadership.
• Establish, scale and nurture regional and strategic account relationships at multiple levels with the partner.
• Maintain a strong focus on helping the market understand Bicycle Health’s unique value proposition.
• Utilize financial modeling to assess the sustainability of Payors rate structure and/or proposed rates for new accounts or account rate changes.
• Contract with new partners and negotiate sustainable rate schedules implementing bundled or value-based pricing strategies whenever possible.
• Ensure contract language is consistent with Bicycle Health’s interests.
• Implement Payor Contracts to maximize potential revenue and pull through opportunities.
• Expand upon existing relationships to increase the value of the account by renegotiating rates, introducing value-based models, and/or expanding go-to-market efforts.
• Complete all designated profiles and documentation on new deals to be reviewed.
• Document progress in sales support applications and communicate consistently regarding sales forecasting.
• Become a subject matter expert regarding payor contract implementation and strategic account management for assigned accounts.
• Partner with the internal team included Revenue Cycle Management, Licensing and Credentialing, Compliance, Marketing, Operations, Enrollment and all other stakeholders to ensure contract alignment and execution.
• Regular and predictable attendance is expected.
• All other duties as assigned.

Qualifications

• Bachelor’s degree preferred
• 5+ years of business development experience in the payor sector. Value-based care experience is a plus.
• Existing relationships with, and experience selling value-based products/services to Regional Payors.
• Ability to review contracts, respond with readiness, and negotiate win-win deals with Payors.
• Prior experience working with Revenue Cycle Management teams and contract implementation.
• Strong communicator who can proactively ident