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Vice President of Payor Relations - Remote

Company: Ivy Rehab
Location: White Plains
Posted on: June 6, 2021

Job Description:

VICE PRESIDENT OF PAYOR RELATIONS - REMOTE

Who is Ivy Rehab?

The Ivy Rehab Network was founded in 2003, and over the past 17 years it has grown into a leading national provider of outpatient physical, occupational, and speech therapy services. We are one of the largest, fastest growing physical therapy companies in the country. At Ivy Rehab we are all about the people and are excited to bring more talent to our technology team. We are a values-based community of professionals that are committed to high performance and dedicated to Caring, Serving, and Growing together.

We operate over 250 clinics in 11 states: New Jersey, New York, Connecticut, Pennsylvania, Delaware Illinois, Indiana, Michigan, Virginia, North Carolina, and South Carolina.

Position Details

The Vice President of Payor Relations leads all aspects of payor relations and contracting, including payor contract negotiation, relationship management, and credentialing. This position is accountable for all aspects of the contract life cycle with new and existing third-party payors, including but not limited to commercial insurance companies, Medicare advantage plans, Medicaid managed care plans, other governmental payors, and Worker's Compensation programs. The qualified individual in this position must handle adverse and difficult situations, as these directly affect the financial performance of the organization.

This role reports directly to the Chief Development Officer, with a dotted line to the Vice President of Revenue Cycle. In this role, it is expected that you will lead and direct various projects as they relate to Payor Relations initiatives, but also be willing and able to take direction as needed when collaborating with other departments in the organization. Critical responsibilities include leading Ivy Rehab's payor strategy across the enterprise, establishing, developing, and maintaining key relationships with payor stakeholders, establishing KPIs for optimal payor reimbursement performance and for the organization's overall financial performance while ensuring consistent compliant billing practices in conjunction with all governmental regulations and other third-party payor requirements.

ESSENTIAL JOB DUTIES AND FUNCTIONS

Contract Negotiation & Implementation

  • In collaboration with leadership, identifies appropriate contracting and re-contracting opportunities and initiates discussions with key constituents
  • Builds and maintains positive ongoing relationships with all third-party payors, with the objective of maximizing market share and revenues
  • Monitors, analyzes and manages contract performance, requirements, and reconciliation
  • Assesses risk exposure and upside/downside opportunities, and coordinates feedback from Clinical Operations, Rev Cycle, and Finance staff to guide all contract-related decisions
  • Leads smooth implementation and integration of new payor contracts into day-to-day operations
  • Develops and leads best-in-class contracting & credentialing diligence and integration efforts with new partnerships
  • Prepares ad hoc and routine (e.g., daily, weekly, monthly, quarterly) reports as needed

Contract Management

  • Builds and manages a comprehensive contract database, which tracks critical contract-specific information around payor-specific requirements, reimbursement, and limitations
  • Regularly works with Clinical Operations and Front / Back End Revenue Cycle to publish payor-specific updates
  • Serves as a subject matter expert for Clinical Operations and Revenue Cycle teammates regarding regulatory updates as well as payment, denial, and utilization trends

Relationship Management & Issue Resolution

  • Identifies gaps and compliance concerns in partnership with Revenue Cycle through development of standardized tracking and reporting tools and routine audits / retrospective analysis of ledger
  • Coordinates and conducts routinely scheduled meetings with high profile and/or high- volume payors to identify and resolve problems/issues, e.g., underpayments, audits, in a timely manner

Credentialing

  • Design and oversee credentialing, re-credentialing, and enrollment process, collaborating with stakeholders across multiple departments to ensure a smooth transition of providers when on-boarding, for new contracts, and during acquisitions
  • Develop, coach, and lead a team of seven teammates responsible for contracting, credentialing, and payor relations for a wide-ranging portfolio of agreements in multiple markets
  • Manage day-to-day operations within the credentialing and provider enrollment function, establishing best practices and KPIs to minimize delays and loss of revenue
  • Perform other duties as assigned

REQUIREMENTS

  • Bachelor's Degree in finance, business, health care administration, or related field
  • 10+ years progressive leadership responsibility and experience in large healthcare organizations
  • 5-10 years strategic management of healthcare pricing, contract negotiation, and healthcare economics in a complex, national or multi-state healthcare system
  • Successful experience establishing relations with commercial and federal payors including contract negotiation and reimbursement optimization
  • Ability to follow, read and interpret insurance contracts
  • Expertise with various reimbursement management areas such as patient billing, collections, cash posting, credit balance, resolution and other basic reimbursement functions
  • Demonstrated competency working with teams and the ability to communicate effectively with all levels
  • Demonstrated experience and leadership in creating new processes as well as quality, process and performance improvement techniques
  • Proficient in the use of Microsoft Office-Word, Excel, PowerPoint
  • Advanced analytical and problem-solving skills
  • Strong interpersonal and communication skills (written and verbal)

Keywords: Ivy Rehab, White Plains , Vice President of Payor Relations - Remote, Other , White Plains, New York

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