VP of Payer Relations and Reimbursement

Description

Why You Will Love Working With Us!

Odyssey Behavioral Healthcare believes that each person deserves the opportunity to embark on a new journey to reach their optimal level of health. Odyssey’s network of behavioral healthcare services provides support to individuals throughout their journey by combining compassionate, evidence-based treatment with concierge-quality amenities.

What we offer:

•        Collaborative environment dedicated to clinical excellence
•        Multiple Career Development Pathways
•        Company Supported Continuing Education & Certification
•        PPO & HDHP Health Plan Options
•        Flexible Dental & Vision Plan Options
•        100% Company Paid EAP Emotional Well-Being Support
•        100% Company Paid Critical Illness (with health enrollment plan)
•        100% Company Paid Life & ADD
•        401K with Company Match
•        Company-Sponsored HSA, FSA, & DSA Tax Savings Accounts
•        Generous Team Member Referral Program
•        Parental Leave

How You Will Contribute/Position Summary

The VP of Payer Relations and Reimbursement cultivates and maintains strategic partnerships with government and commercial payers. Position serves as the primary contact for payer relations, negotiations, and contracting across a diverse payer landscape. The VP of Payer Relations and Reimbursement supports the overall growth of the company by aligning growth initiatives with payer contracts.

Essential Responsibilities

1. Collaborates with key leaders to contribute to national strategic growth plans by evaluating, analyzing, and interpreting the payer landscape within a given market; establishes payer connections ahead of market entry.
2. Provides executive team updates related to market trends, additional business opportunities, and obstacles within new and existing markets and service lines.
3. Cultivates and maintains long-term relationships with government and commercial payers that align with Odyssey’s growth and service delivery goals.
4. Leads negotiation, drafting, and execution of payer contracts, in collaboration with executive leaders, ensuring contract terms support Odyssey’s financial and clinical service objectives.
5. Develops innovative pricing models and contract structures that maximize value and sustainability.
6. Monitors contract performance regarding financial performance, payment integrity, and compliance with contract terms and key performance indicators.
7. Monitors payer activity with respect to network development, service line expansion and development, payment policies and other relevant market intelligence.
8. Collaborates cross-functionally with internal teams to ensure payer strategies are aligned with business goals and operations.
9. Oversees the credentialing process for the company and company providers.
10. Communicates key contract requirement to ensure operational compliance and success.
     

Additional Responsibilities

1. Maximizes available resources to meet or exceed strategic growth goals.
2. Performs other duties as assigned.

Qualifications

What We Are Seeking/Education and Experience:

The position requires a minimum of a bachelor’s degree from an accredited college or university, preference for master’s level education. Payer contracting experience within a behavioral healthcare delivery setting, with a proven track record of negotiating favorable contract terms, managing expectations, and driving positive financial outcomes. Must possess a deep understanding of government and commercial payer priorities and the dynamics of healthcare reimbursement.

Skill Competencies

• Demonstrates excellent organizational, time management, and negotiation skills.
• Demonstrates the ability to collaborate with a variety of stakeholder groups.
• Demonstrates a strong understanding of the commercial payer landscape and priorities.
• Demonstrates proficient data management and interpretation skills, utilizing a variety of sources.
• Demonstrates excellent computer/technology skills including MS Office.
• Demonstrates the ability to consistently exercise sound judgment and discretion.
• Demonstrates excellent verbal and written communication skills with a variety of internal and external stakeholders.
• Demonstrates alignment with Odyssey’s vision, treatment philosophy, and core values.

Odyssey Behavioral Healthcare provides equal employment opportunities without regard to race, color, creed, ancestry, national origin, ethnicity, sex, gender, sexual orientation, marital status, religion, age, disability, gender identity, genetic information, service in the military, or any other characteristic protected under applicable federal, state, or local law. Equal employment opportunity applies to all terms and conditions of employment. Odyssey Behavioral Healthcare reserves the rights to modify, interpret, or apply this job description in any way the organization desires. This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position. Reasonable accommodations may be made to reasonably accommodate qualified individuals with disabilities. This job description is not an employment contract, implied or otherwise. The employment relationship remains “At-Will.”