Director, Payer Relations Cleveland HeartLab
Cleveland HeartLab, Inc. (CHL) is a premier next-generation clinical reference laboratory committed to advancing cardiovascular risk assessment through unique and proprietary diagnostic tests. We focus on novel inflammatory and cardiovascular biomarker technologies that allow for advanced risk assessment.
We are seeking a Director, Payer Relations to develop, implement and lead a payer relations strategy for this clinical reference lab that specializes in novel biomarker technologies for cardiovascular and other chronic diseases, including payer analysis, outcomes documentation, contract negotiations and implementation.
The essential responsibilities include:
Develop analytics on current payers, by test, by geography that can be routinely updated and maintained as baseline for strategies, including denials, payment accuracy and compliance with medical policy to maximize health plan reimbursement.
Lead development of payer toolkits and/or evidence based documentation to present to payers as justification for contracts and reimbursement rates.
Collaborate with Sales and the Leadership Team on payer strategies for top 50 customers; develop education and training for sales team & customers.
Participate in design and implementation of systems and business intelligence to support the company payer strategies.
Lead company pricing strategies across all customer segments, both direct pay and reimbursed by 3rd parties (Insurance, Medicare and Patients).
Build long term, sustainable relationships with payers and company.
Insure compliance in all business relationships and transactions.
Job qualifications include:
Degree ? B.S./B.A. required; MBA or other advanced degrees, preferred.
Knowledge of cardiovascular products and testing; strong science/medical background.
Broad laboratory industry knowledge.
Experience with a clinical laboratory/diagnostics which is reliant upon medical reimbursement from government and insurance payers.
Strong communication and presentation skills.
Command of Microsoft suite, especially Excel and PowerPoint.
Experience with LIS, ERP and CRM Systems.
Drive and hands-on approach, required in a fast growing, entrepreneurial company.
Demonstrated ability to achieve results.
Work location ? Cleveland, Ohio preferred; other locations ?optional.
We offer an excellent benefits package which includes medical, dental, vision, life and disability along with a matching 401K plan.
It is the policy of Cleveland HeartLab to consider candidates without regard to race, color, religion, gender, national origin, ancestry, genetic information, age, disability, or any other condition protected by applicable law. We are a drug free workplace.
||Cleveland, OH |