Vice President of Payer Strategy (70193)
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Job Location:
Monthly Salary:
Posted on:
15 hours ago
Vacancies:
1 Vacancy
Job Summary
Womens Care founded in 1998 is a leading womens healthcare group in the United States dedicated to providing the highest quality of care for women through their reproductive years and beyond. With 100 locations and over 400 OB/GYNs and specialists across the country Womens Care provides comprehensive patient care in obstetrics gynecology gynecologic oncology urogynecology gynecologic pathology breast surgery genetic counseling maternal fetal medicine laboratory services and fertility.
The Vice President of Payer Strategy leads Womens Cares enterprise-wide managed care strategy overseeing payer relationships fee-for-service and value-based contracting reimbursement optimization and negotiation strategy across all markets. The role materially influences the organizations financial performance by securing favorable reimbursement improving contract terms and strengthening long-term payer partnerships.
This position collaborates closely with senior leadership and cross-functional teams to prepare for negotiations execute contracting strategies and ensure effective implementation of payor agreements. The role also partners with Revenue Cycle Management to resolve takebacks recoupments denials underpayments and related compliance issues.
Additionally the VP of Payer Strategy oversees the credentialing function ensuring timely provider enrollment adherence to payer and regulatory requirements accuracy of credentialing databases and maintenance of delegated credentialing status.
- Lead enterprise payer strategy including national and regional payer relationships contract negotiations renewals and performance management
- Negotiate fee-for-service value-based and alternative payment model agreements; achieve targeted financial outcomes and growth goals
- Redline and review managed care contract language and reimbursement provisions; recommend improvements
- Drive analytical processes and performance documentation related to negotiation strategies managed care rates reimbursement trends and contract performance
- Partner with Finance Revenue Cycle Operations and Clinical Leadership to implement contract terms optimize revenue capture and resolve payer issues including denials underpayments takebacks and payer compliance issues
- Develop and deliver clear communication plans for negotiations contract changes credentialing updates and payer developments
- Stay current on market trends regulatory changes reimbursement methodologies and competitive dynamics
- Oversee credentialing operations ensuring efficiency accuracy and compliance with payer regulatory and accrediting requirements
- Demonstrates and embodies the Womens Care mission and core values.
- Compliance with all HIPAA rules regulations and guidelines.
- Other duties as assigned.
Qualifications
Qualifications:
- Bachelors degree required; Masters degree preferred
- 15 years progressive healthcare leadership experience including at least 7 years in managed care contracting within physician groups or payers
- Demonstrated success leading negotiations of fee-for-service and value-based agreements using quality data market benchmarks and payer performance history
- Advanced proficiency in Excel; experience with BI tools (Power BI preferred) and contract management platforms strongly desired
- Strong financial acumen analytical capability and ability to interpret complex contracts
- Excellent communication presentation and relationship-building skills
- Proven ability to lead teams drive accountability and operate effectively in a fast-paced environment
- Hands-on execution-focused leader comfortable with both strategic and tactical responsibilities
- Deep knowledge of commercial insurance products reimbursement methodologies and market dynamics
- Requires effective communication with internal leaders providers external partners and payer executives. Must manage multiple priorities and operate effectively in a fast-paced evolving environment.
- Role requires regular in-office presence in Tampa FL
WHY JOIN WOMENS CARE
We Offer:
- Competitive compensation package
- Health dental and vision benefits
- Paid time offand paid holidays
- 401k plan
- An opportunity to make a difference in patientslives every day!
Womens Care has grown tremendously through the years and expects to accelerate its growth with plans to expand rapidly into new markets across the U.S. With the commitment of our employees we remain true to our mission of Improving the Health of Women Every Day. At Womens Care weCAREabout our patients and we stand by our values.
Compassion & Empathy: Treating patients like valued friends and family
Accountability: Taking responsibility for our actions and behaviors
Respect: Acting respectfully in every interaction
Excellence & Quality: Providing the safest highest quality of care
Required Experience:
Exec
Key Skills
- Change Management
- Financial Services
- Growing Experience
- Managed Care
- Management Experience
- Analysis Skills
- Senior Leadership
- Performance Management
- Process Management
- Leadership Experience
- negotiation
- Analytics
