Director, Payor Contracting
At VillageMD, we are committed to helping patients achieve greater health by delivering the most effective, accessible and efficient healthcare in the world through partnership with primary care physicians. We are in a unique position to impact everyone in primary care from independent, family-owned practices to world-class health systems. We leverage a tested model of care that combines value-based contracting, data-driven decision-making, ancillary services development, and the capital needed for success. Establishing strategic partnerships with provider organizations and payers across the nation, our goal is to innovate for the future while retaining the best aspects of the traditional practice of medicine.
Integral to our team, the Director of Payor Contracting will be accountable for driving successful payor partnerships through development and execution of agreements that support the VMD business model, particularly our physician partners and patients served. This individual will be responsible for both leading and supporting payor negotiations with an emphasis on building strong, collaborative payor relationships that support innovative reimbursement structures to advance the best interest of high quality, affordable patient care.
What you might do in your first year:
- Negotiate complex, value-based payor agreements, and participate in the strategic development of payor contracting initiatives in assigned markets
- Implement the contract structures and reimbursement methods and rates for all professional, institutional, ancillary and vendor providers in assigned markets
- Work closely with Operations team members to ensure that key provider support processes are well functioning
- Negotiate and improve upon stop loss provisions
- Improve deal terms for quality measures
- Participate in business development efforts and initial outreach
What will make you successful here?
- Ability to be proactive with strong personal initiative as well as highly organized and detail oriented.
- Effectively contributing to building collaborative payor relationships that result in advantageous contract arrangements
- Understanding of medical cost trends that drive gains and losses across risk pools
- Ability to navigate within ambiguity, a service orientation, and a high level of humility are vital for successful assimilation into our highly collaborative, entrepreneurial culture
- Strong knowledge of Medicare Advantage bid process and payor funds flow
- Knowledge and understanding of health plan network operations preferred
What you bring to VillageMD:
- Demonstrated track record of building strong working relationships across operational leaders and potential payor partners.
- Bachelor’s degree in Business required
- Minimum of 10 years in progressive roles required
- Demonstrated analytical, project management, and leadership skills
- Experience modeling payor contracts
- Knowledge of value-based contract methodologies and preferred financial and administrative terms
- Experience negotiating quality and efficiency metrics preferred
- Ability to think independently, and develop new processes/analyses required
- Strong organizational skills with the ability to multi-task and execute against multiple competing priorities
- Proficiency in Excel, PowerPoint, and Word required
At VillageMD, we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.