VP- Payer Strat & Managed Care

Northern Light Health Home Office |US:

ME:

Brewer or Hybrid | Leader - Non Clinical | Full Time

Salary range- - USD

The compensation range listed reflects the range Northern Light Health anticipates relying on in setting the wages for the position. The range may not necessarily include all additional compensation elements available, such as differentials, incentive programs and benefits.

Northern Light Health

Department:Managed Care Contracting

Position is located:Cianchette Professional Blding

Work Type:Full Time

Salary Range : $ -$340, 270.00

Exempt:
Yes

Summary
:

The vice president of payer strategy & managed care operations oversees all aspects of payer contracting and relations with responsibility for the strategy, negotiation and execution of fee-for-service and value-based contracts for Northern Light Health (NLH) and all its subsidiary member organizations. The vice president is responsible for managing the contractual relationships between NLH’s business partners (e.g. employers) and payers to assure strategic alignment across the NLH Enterprise.

Reporting to NLH’s senior vice president (SVP) & chief financial officer (CFO) and partnering with NLH’s vice president & senior counsel on legal, strategic and relevant operational matters. The vice president collaborates with other key NLH stakeholders. These stakeholders include, but are not limited to the, SVP of strategy, SVPs of member organizations including Beacon Health, VPs of finance of member organizations, VP of finance, VP revenue cycle and the AVP of finance & analytics.

The vice president leads a team of contract managers and consultants that are responsible for negotiating and managing contracts with business partners and payers.

The vice president of payer strategy & managed care operations is accountable for the overall financial and operational performance of NLH’s contracts with commercial payers such as Aetna, Anthem, Cigna and United Healthcare and other third-party contracts impacting gross to net patient service revenue amounts for member organizations including Beacon Health. Contract performance with commercial payers relates to the financial yield that the contracts produce and to the administrative burden required to support these contracts.

The vice president is similarly responsible for aligning both the tactical (near-term) and the strategic (long-term) objectives of NLH in each contract. Informing and influencing NLH senior leaders regarding emerging trends, obstacles and opportunities relative to industry and governmental developments related to payer/provider reimbursement methods and schemes is central to this function.

Supporting the professional development of the payer strategy & managed care operations team is another central function of the vice president. Creating a high-performance team of professional contract negotiators that work collaboratively to achieve NLH’s revenue objectives as the healthcare industry migrates for fee-for-service to value-based reimbursement is essential to NLH’s financial viability. Establishing a robust and effective relationship with the Revenue Cycle, Finance & Analytics and Information Technology Teams is vital to the overall success for this position.

Responsibilities
:

• Leads by example and manages a team of highly effective contract managers and contract consultants that are responsible for negotiating and supporting contracts with business partners and payers
• Collaborates with Revenue Cycle, Finance & Analytics, Beacon Health, member organizations and other departments to achieve financial and operational success for the NLH Enterprise
• Develop a payer strategy that supports the NLH near and long-term financial and operational goals
• Assist NLH’s effective…