Sr Director Managed Care and Payor Strategy

Sr Director Managed Care and Payor Strategy

PURPOSE AND SCOPE:

The Senior Director of Managed Care & Payor Strategy is a strategic leader responsible for driving initiatives that strengthen relationships with Managed Care Payor Organizations and optimize contractual performance.

This role leads a high-performing team, fostering collaboration and innovation to achieve organizational goals in managed care contracting, quality outcomes, and marketing strategies.


* Manages contracting and relations with managed care organizations.


* Develops long-term strategies and tactics for managed care contract review and analysis.


* Leads the initiation, negotiation, and execution of contracts.


* Oversees the maintenance of relationships and issues resolution with managed care organizations.


* Ensures all contracts are compliant with internal and governmental regulations.


* Supports and improves employee engagement & team culture


* Supports FMCNA's mission, vision, values and philosophy.


* Adheres to the FMC Compliance Program, including following all regulatory and FMS policy requirements.

PRINCIPAL DUTIES AND RESPONSIBILITIES:


* Formulates market strategies and develop an implementation plan for a contract portfolio that involves multiple sites, geographies and products.


* Leads the end-to-end negotiation of national and regional payor agreements, including initial rate development, contract language negotiation, and oversight through final implementation of executed agreements.


* Represent Fresenius Kidney Care services to payors and other stakeholders through compelling presentations and communications.


* Develops direction, goals and priorities of team members.


* Oversee the evaluation, analysis and preparation and completion of Managed Care contract proposals for direct reports.


* Outlines revenue targets as team initiatives and manages collective and individual performance towards achievement of goals.


* Provides clear, accurate guidance to leadership team and operational partners regarding contracting targets, goals and objectives.


* Collaborates effectively with Operations, Clinical and Support teams to implement strategy and achieve goals.


* Works closely with Operations and leadership to maximize growth opportunities and strengthen payor partnerships.


* Assists senior management in the preparation of financial budgets and quarterly forecasts.

QUALITY:


* Responsible for leading team responsible for negotiating and implementing contracts with payers that require clinical and quality outcomes measurements.


* Responsible for the design and implementation of third party payor compensation structures including quality outcome measures, pay for performance, risk and various other structures and metrics.


* Responsible for ensuring that quality and financial outcomes are reported accurately and in a timely manner.


* Assist with designing Qualit...