Manager, Payor Relations

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues serve people in more than 160 countries.

     

JOB DESCRIPTION:

Job Title

Manager, Payor Relations

Working at Abbott

At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to:

• Career development with an international company where you can grow the career you dream of.
• Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year.
• An excellent retirement savings plan with a high employer contribution.
• Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree.
• A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune.
• A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists.

The Opportunity

This position works out of our Livermore, California location Abbott Heart Failure, Acelis Connected Health business.

Acelis Connected Health’s DME & IDTF businesses operate across all states in the US with several hundred payor plans to serve it’s 80,000+ patients on service. This Manager, Payor Relations will be critical to develop strategies and drive ongoing activities requires to serving and expand access to patients. These activities include leading the development, implementation, and monitoring of processes related to commercial payor contracting. These processes span end-to-end contracting across all lines of business at Acelis Connected Health.

What You’ll Work On

The following reflects essential functions for this job, but does not restrict the tasks that may be assigned. Management may assign or reassign duties and responsibilities to this job at any time due to reasonable accommodation or other reasons.

• Accountable and responsible for performing essential activities and process improvement related to commercial payor contracting across all lines of business; specific contracting activities include, but are not limited to:

  • Contract redlining

  • Contract implementation

  • Contract monitoring

  • Contract management, including initial & ongoing credentialing

  • Payor escalation management, including payment discrepancy resolution

• Maintains contracting governance processes to ensure alignment to contract onboarding & management with cross-functional stakeholders, including: finance, commercial operations, and revenue cycle management

• Develops, maintains, and presents to leadership the KPIs/metrics related to areas of responsibility

• Represents the payor relations function as a core team member on cross-functional projects

• Contributes to business strategies related to commercial contracting and payor management; examples include: patient access, pricing, payor management

Required Qualifications

• Bachelor’s Degree in a business discipline

• 8+ years relevant experience in payor contracting at a healthcare provider, payor, or network

• Demonstrated ability to develop, improve, and monitor commercial contracting processes

• Ability to work independently and managing competing priorities routinely.

Preferred Qualifications

• Master’s Degree in related field

• 5+ years experience in payor contracting within the DME/IDTF provider space

• 5+ years experience working directly with CMS (Medicare/Medicaid) and The Joint Commission

Physical Requirements

• Must be able to work at a computer workstation for extended periods of time.