National Director, Payer Relations Oxford Immunotec
THIS JOB HAS EXPIRED Overview:
A strategic, highly visible position responsible for the identification, development and management of strategic relationships with payers and organizations that influence payer decision-making in the US. Key objectives of the role are to work cross-functionally to obtain managed care agreements with acceptable rates, influence and achieve favorable payer coverage policies, and work with key state Medicaid accounts to achieve favorable coverage policy and payment rates.
Develop and implement strategies to negotiate and manage contracts with commercial and government payers to secure and/or optimize reimbursement, access, policy and processes.
Establish formal contracting criteria and processes to facilitate efficient, consistent and timely interaction with managed care payers.
Develop and implement strategies for influencing and achieving positive coverage policy in targeted payers.
Assist and coordinate strategies with reimbursement team to maximize revenue. Activities may include resolving payment issues, identifying state Medicaid opportunities and influencing coverage policy.
Coordinate with VP Sales, Area Sales Directors and Territory Managers to leverage customer support in the effort to payer coverage policy.
Develop and implement strategies to gain access to Medicaid in key states (e.g., Texas, California).
Monitor and report financial and operational performance and compliance with managed care contract terms to ensure that appropriate management systems are in place.
Participate in the budget, financial planning and accounting processes concerning expected managed care volume, revenue, contractual allowance, and product cost assumptions and calculations.
Achieve and continually grow positive working relationships, centered around trust, between Oxford and managed care entities.
Develop and update payer-specific action plans and next steps.
Regular attendance and timeliness is essential.
Bachelor?s degree in Science, Business, Marketing or related field, advanced degree a plus
Minimum of 5-7 years in healthcare or managed care finance
Knowledge and proven track record in the field of reimbursement of diagnostic products.
Experience and a proven track record of success in payer coverage and contracting
Proven experience and relationships with commercial insurance decision-makers and influencers
Experience and proven track record of overcoming new payer challenges (examples: dialysis patients and nursing home reimbursement)
Strong analytical skills and with a high level of attention to detail
Demonstrated leadership skills and track record of taking initiative
Demonstrably high levels of communication (both written and verbal) and public speaking skills
Strategic planning orientation; knowledge of industry dynamics and abilityto move the contracting strategy forward by successfully adapting to these dynamics
Extensive travel required.
The physical demands described within the Position Responsibilities section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to be independently mobile. The employee is also required to interact with a computer, and communicate with peers and co-workers. Frequent travel is required.
||Marlborough, MA |
THIS JOB HAS EXPIRED