Regional Director Payor Relations

Overview

Concentra is recognized as the nation’s leading occupational health care company.With more than 40 years of experience, Concentra is dedicated to our mission to improve the health of America’s workforce, one patient at a time. With a wide range of services and proactive approaches to care, Concentra colleagues provide exceptional service to employers and exceptional care to their employees.

 

The Regional Director, Payor Relations develops, manages and maintains relationship to assigned payer accounts for a book of business with annual revenue up to and exceeding $100MM. Manages self as well as team’s implementation of regional and national sales and account management of current and future product offerings to assigned clients consisting of (and not limited to) the following: horizontal selling (growth), lead generation, developing and increasing direction of care, building brand awareness, service and issue resolution, implementing and executing uniquely defined mutual strategies, stewardship reporting, client consultation and overall customer satisfaction of all assigned accounts.

Responsibilities

Develop and manage self and the team’s successful relationships with assigned group of payor accounts, consisting of Insurance Carriers, Third Party Administrators, Managed Care/Managed Provider Networks, Professional Organizations, PBM, and Specialty Networks

• Responsible for expanded knowledge of all of Concentra’s product offerings and the sales and execution of such, focusing on growing the clinic penetration and market share for zone exceeding assigned revenue growth for each assigned account• Participate in continuing education programs on company products, services, sales training and industry compliance• Implement Regional, National and Integrated Sales strategies and programs into the local market• Maintain productivity to meet and exceed the budgeted incremental revenue expectations• Conduct, lead and sponsor external presentations/stewardship/meetings/strategy meetings• Territory management which includes payor office visits and meeting with claims manager, supervisors, adjusters and nurse case managers• Participate in goal setting strategy sessions monthly and quarterly which are specific to mutual accounts between payer and division

Participate with internal teams to assist in the development of customer specific customer service protocol and strategies. Assist in improving services delivered at the Center/Centers.• Continually evaluate the need for needs assessments, sales call/product presentations, sales proposals and expansion, rate negotiation, providers and benefit comparisons, coordination of installation and implementation of services sold• Interface with internal departments to assist with developing and setting account strategy, managing contracting and price increases and understanding and controlling total profitability of assigned account(s)• Manage personal and Payor Director reporting through C4 activity• Maintain and submit to Vice President/SVP Sales of Payer Relations periodic outcome, pipeline forecasting, revenue performance (growth), statistical reports and issue resolution• Meet or exceed periodic growth goals and product expansion established with supervisor• Identify problems with assigned/unassigned payor/TPA/network accounts and facilitate timely solutions with specific company business unit. Serve as main contact between payer issues and division resolution• Develop payor sales lead efforts with zone and regional sales team and other zone disciplines in order to meet or exceed growth goals• Responsible for review and analysis of the financial performance of assigned territories to sales, area and zone management• Participate in and assist with continuing education programs for client• Participate in and assists with coordination of payer audits by working with Central Billing Office (CBO) to ensure appropriate reimbursement for services rendered• Meet with regional and corporate leadership in various areas to review quality of care• Act as primary client facing relationship to assigned payors

 

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Qualifications

Education Details: • Bachelor’s degree in Business Administration, Marketing or related field from an accredited college, or combination of education and related-work experience and training• In lieu of an undergraduate degree, the ratio is 1:1 meaning one year of college is equal to one year of directly related work experience and vice versa

 

• Customarily has at least the following experience: 7 years• Customarily has at least seven or more years of experience in healthcare, P&C Insurance, Worker's