E00501 – Vice President of Reimbursement Strategy

Position Overview: The Vice President of Reimbursement Strategy directs contracting and relations with managed care organizations. Leads development of company value proposition with senior leadership and develops offering around value based offerings. Develops long-term strategies and tactics for managed care contract review and analysis. Leads the initiation, negotiation, and execution of contracts. Oversees the maintenance of relationships and issue resolution with managed care organizations. Ensures all contracts are compliant with governmental regulations.

 

Specific Responsibilities:

• Develops pitch of Genetworx value proposition.
• Sell GENETWORx’s services to prospective and existing managed care clients.
• Establish relationships with new and existing customers that can lead to increased revenue growth.
• Contract with National and Regional payor groups through different value offerings including value based contracting.
• Works with payor groups to determine their needs and shares business intelligence with senior management to develop growth strategies.
• Identify business opportunities with new and existing customers that can be memorialized into contractual commitments.
• Develops business relationships with key account decision makers and influencers at a Director and VP level. Manages GENETWORx’s relationship with the account and acts as the primary point of contact within Genetworx for the account.
• Analyzes customer needs and strategic direction, collects intelligence on competition, and determines opportunities to improve contract profitability and strengthen GENETWORx’s strategic position.
• Manages the contracting process including contract amendments, rate negotiation, rate approvals, language review, execution, and implementation of executed agreements both with the customer and internally.

• Monitors revenue and profitability trends and key account performance indicators to ensure results are being achieved.
• Completes reports on contract opportunities and progress in achieving assigned objectives.

 

Education and Experience:

• Bachelor’s degree from 4-year college is required in Business, Finance, Health Administration or related degree. MBA preferred.
• 8+ years’ work experience required; four in a Managed Care or health care provider organization.
• Demonstrated ability to deliver results and execute on business plans.
• Financial acumen with an understanding of financial models.
• Strong negotiation skills.
• Proactive strategist with ability to anticipate market changes and trends
• Demonstrated account management experience.
• Excellent oral and written communication skills
• Proficient in Microsoft Office Suite

 

Competencies:

Creating the New and Different: The ability to generate new ideas and breakthroughs requires vision, creativity, and broad interests and knowledge. Must also be able to speculate about alternatives, manage the innovation process and teams, and bring those ideas to market.

 

Impact and influence: Works effectively with and through others including those whom there is no formal authority.

 

Business Acumen: Ability to develop and administer multi-million budgets with a strong bottom-line mentality. Understands the levers that make the biggest impact.

 

 

Work Environment: This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets. The noise level in the work environment is usually moderate.

 

Physical Demands: While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands to finger, handle or feel objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move objects up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus.

 

Travel: Travel is primarily local during the business day, although some out-of-the-area and overnight travel may be expected.