VP Payor Relations

*This is a remote position*

Work with a purpose! Thrive Skilled Pediatric Care’s purpose is simple, to provide high quality clinical home care to medically fragile children so they can grow and flourish to their full potential. We deliver this through our commitment to our purpose, through our passion for what we do, and pride in what we contribute to which is the health and well-being of children and their family. 
 
The Vice President, Payor Relations is responsible for overseeing the payor relations operations and strategy within Thrive Skilled Pediatric Care. This role involves strategic leadership, contract management, operational oversight, financial performance, and ensuring compliance with industry regulations. The VP of Payor Relations works closely with the Senior Leadership team to integrate operations and strategies with the overall goals of the organization.
 
It would be particularly valuable in this role to have contacts in Texas as this is our largest market.  These relationships can help in negotiating contracts, understanding regional market dynamics, and addressing specific challenges unique to that area.

Requirements:

• Master’s degree preferred. Bachelor’s degree required with a minimum of 8 -10 years of extensive experience in a leadership role with healthcare providers or payors with oversight of payor contracting and payor relations.
• Experience leading cross functional teams with large payor initiatives.
• Strong understanding of value-based care programs with a proven track record of obtaining and managing value-based contracts.
• Proven ability to collaborate with internal stakeholders including finance, clinical, operations, business development and health delivery teams.
• Success in leading teams through multi-site and multi-state payor contract negotiations, implementation, and management.
• Possess critical thinking skills necessary to analyze data and synthesize complex information.
• Strong knowledge of and experience in process improvement and facilitation.
• Demonstrated skills and experience in collaboration, negotiation, problem identification and resolution.
• Advanced knowledge of Microsoft Excel, Word, PowerPoint.

Essential Responsibilities:

• Provide vision and direction for payor relations, including value-based care initiatives and payor relationships.
• Lead the negotiation, implementation, and management of contracts with health plans, insurance companies, and payors.
• Develop and implement payer strategies and value-based care reimbursement strategies that optimize clinical outcomes and achieve positive financial performance.
• Ensure contracts are financially viable and aligned with Thrive Skilled Pediatric Care’s goals.
• Manage and optimize payor relationships to enhance contract performance and facilitate resolution of issues.
• Liaison for revenue cycle teams for troubleshooting payment and collection issues with Payers.
• Partner with senior leadership team to implement strategic initiatives that lead to payer optimization and improved financial performance.
• Ensure that payor contracts and practices comply with regulatory requirements and industry standards.
• Develop and monitor metrics to asse and improve the quality of care provided under payor agreements.
• Spearhead business development efforts through utilizing payer relationships to access new channels and patient populations.
• Collaborate with senior leadership to address and resolve compliance issues and audit findings related to payor contracts.
• Assist senior leadership to grow the company's footprint in new and existing markets by leveraging payer relations to identify opportunities to expand market presence.
• Perform other duties as assigned.

About Thrive Skilled Pediatric Care
Thrive Skilled Pediatric Care provides care to children who most need it, in the place that is best for them and their families – their home. We offer a full range of clinical home care services and work collaboratively to ensure our patients receive the highest quality care for the best possible outcomes.
 
Thrive SPC team members work in a rewarding, supportive, and values-driven environment, with comprehensive benefits and best-in-class development programs designed to advance their careers. Our goal is to be the employer of choice in pediatric home health care.

For more information about Thrive SPC, visit our website at www.thrivespc.com