Manager, Payor Partnership Analysis

We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.

Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.

When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

At VillageMD, we're looking for a Manager of Payor Partnership, Analysis to help us transform the way primary care is delivered and how patients are served. As a national leader on the forefront of healthcare, we've partnered with many of today's best primary care physicians. We're equipping them with the latest digital tools. Empowering them with proven strategies and support. Inspiring them with better practices and consistent results.

We're creating care that's more accessible. Effective. Efficient. With solutions that are value-based, physician-driven and patient-centered. To accomplish this, we're looking for individuals who share our sense of excellence, are ready to embrace change, and never settle for the status quo. Individuals who have the confidence to lead but the humility to never stop learning.

Could this be you?

Integral to our team, the Manager of Payor Partnership, Analysis will be accountable for driving successful payor and provider partnerships through development, execution, and management of analysis of payor reimbursement and contract performance which support the VillageMD business model.  This individual will be responsible for supporting negotiations with both payors and providers with an emphasis on building strong, collaborative relationships that support innovative reimbursement structures to advance the best interest of high quality, affordable patient care.

How you can make a difference

• Develop and build models to help VillageMD analyze reimbursement rates and identify areas of improvement.
• Assist in operational and financial support of implementation of VMD’s Payor Contracting business plan, achievement of operating results, and strategic priorities.
• Provide insights to help negotiators utilize various contract methodologies, actuarial approaches, and financial strategies to optimize the value of payor agreements.
• Maintain strong interpersonal relationships within VillageMD departments, including Revenue Cycle, and Finance.
• Build relationships with senior level operations leadership to understand multifaceted business problems and develop analytical solutions to complex issues.
• Own the process of monitoring performance in fee-for-service contracts across multiple payers.
• Mine patient and healthcare provider data from multiple sources, including medical claims data, pharmacy claims data and clinical data from electronic medical records, to discover key analytical insights for decision support.

Skills for success

• Ability to be proactive with strong personal initiative as well as highly organized and detail oriented.
• Understanding of reimbursement models, CPT/HCPC codes, Medicare, Medicaid and Commercial Managed Care Payors.
• Excellent verbal and written communication skills; ability to convey complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others, including but not limited to reimbursement policy standards.
• Strong interpersonal skills, establishing rapport and working well with others.
• The ability to handle multiple, concurrent projects
• Challenging the status quo to improve our processes and tools
• Knowledge and understanding of health plan network operations preferredEffectively contribute to building collaborative payor and provider relationships that result in advantageous contract arrangements and operational excellence
• Knowledge and understanding of health plan network operations

Experience to drive change

• Demonstrated track record of building strong working relationships across operational leaders and potential payor partners.
• Bachelor’s degree in Business required
• 5+ years Payor and/or Provider contracting experience required
• Demonstrated analytical, project management, and leadership skills
• Knowledge of contract methodologies and preferred financial and administrative terms
• 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

This is an exempt position. The base compensation range for this role is $95,000 to $118,800.  At VillageMD, compensation is based on several factors including, but not limited to education, work experience, certifications, location, etc.  The selected candidate will be eligible for a valuable company benefits plan, including health insurance, dental insurance, life insurance, and access to a 401k plan

​preferred

Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families.  Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.

Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.