Senior Director, Payor Relations

Soleo Health is seeking a Senior Director, Payor Relations to lead the company’s national payor contracting and network management strategy, drive reimbursement optimization and strategic growth initiatives, and strengthen executive-level relationships with payors, providers, and healthcare partners. Join us in Simplifying Complex Care!

Soleo Health Perks:

• Competitive Wages  
• 401(k) with a Match 
• Referral Bonus    
• Paid Time Off 
• Great Company Culture  
• No Weekends or Holidays   
• Paid Parental Leave Options 
• Affordable Medical, Dental, & Vision Insurance Plans 
• Company Paid Disability & Basic Life Insurance 
• HSA & FSA (including dependent care) Options 
• Education Assistance Program   

The Position: 

The Senior Director of Payor Relations is an executive role focused on driving the strategic direction, development, and overall management of Payor Relations across the company. This executive will play a critical role in shaping the company’s approach to healthcare contracting and network management at a national level. The Senior Director will lead efforts to optimize the reimbursement Soleo receives for its services through various payor relations strategies, ensuring they align with the company's long-term strategic and financial objectives and maximize the company’s earnings potential. Responsibilities include:

• Formulate and oversee the implementation of comprehensive regional and national Payor contracting and network management strategies. Drive the achievement of contracted sales goals and enhance market share and profitability.
• Lead the identification, development, negotiation, and management of Payor Relations agreements to ensure competitive and sustainable growth.
• Initiate and guide the launch of innovative Payor relations programs and contracts, collaborating with senior internal stakeholders including operations, finance, and Regional Vice Presidents.
• Oversee detailed financial analyses of Payor contracts to assess the earnings impact of new contracts, as well as renewals and material network changes. 
• Manage budget projections for pricing and assess financial performance of payor contracts.
• Ensure Payors are reimbursing Soleo at the contracted rates and that reimbursement is timely.
• Enhance Soleo’s contracting strategy to maximize value (where applicable) using national contracts with chain codes vs. individually contracted pharmacies.
• Serve as the primary executive contact for major external partners, including hospitals, Payor organizations, and manufacturers. Build and maintain strategic relationships to bolster business objectives.
• Oversee the design and implementation of advanced sales training programs that focus on Payor relations, contract comprehension, opportunities, and associated risks.
• Monitor and analyze market trends and contractual activities to identify and seize opportunities for new or expanded Payor agreements.
• Lead the development of performance-based contracting models that reflect the latest in healthcare industry advancements and match organizational goals (i.e., Soleo’s participation in limited payor networks).
• Maintain and update the company's strategy in response to healthcare legislation changes. Act as a subject matter expert to guide Payor Relations policies and practices.
• Manage the creation and ongoing updates of departmental policies to ensure compliance with regulatory, operational, and organizational standards.
• Partner with Revenue Cycle Management team to defend Soleo’s interests in payor audits.
• Manage the creation and ongoing updates of departmental policies to ensure compliance with regulatory, operational, and organizational standards.
• Completes all necessary managerial tasks for direct reports including hiring, training, addressing performance issues, developing team goals and objectives, performance reviews, conflict resolution, and strategic planning.

Schedule: 

Monday-Friday 8:30am-5pm

• Bachelor’s degree in a related field such as business administration, economics or finance with a minimum of 10 years in Payor Relations and Contracting including significant leadership experience in complex healthcare environments.
• High school diploma (or equivalent) required.
• Advanced degrees such as an MBA or Juris Doctorate preferred.
• Strong communication, negotiation, and leadership skills.
• Proven track record of leading high-performing teams and effectively managing senior-level projects and initiatives.
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