Our mission at Progenity is simple: to help healthcare providers and patients prepare for life. We provide the most advanced molecular technology and the highest levels of service to guide patient care at critical life stages. We continually seek people with the motivation and skills to advance our mission.
As the Associate Director, Health Plans, the role will assist and drive payor strategy, contracting and management at a regional level for both existing and future products. This individual will leverage their own experience and relationships to accomplish company objectives. The scope entails the identification and development of new payors, as well as the continued development and deepening of service relationships with existing payor clients.
RESPONSIBILITIES
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Uses resources available such as market databases and Progenity financial reporting to identify and prioritize prospects which enhance the regional territory.
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Helps identify payor financial trends and assist with stabilization, facilitating discussion with payor and billing.
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Identifies depth & maturity of existing client services relationships and develop plans to improve over time.
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Develops direct relationships with sales management, operations and billing.
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Establishes yourself as a market leader that can help identify and fix challenges.
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Seeks opportunities for new patient volumes through payor initiatives.
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Builds and oversees all relationships with our regional health plan customers.
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Participates in activities which result in improved contract performance, which include performing payor analysis and communicating with all Revenue Cycle teams.
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Facilitates the resolution of payer issues utilizing personal contacts, negotiations and problem-solving skills.
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Manages contracting, including assisting in negotiation strategies, gathering data for negotiations, and participating in negotiations to achieve company’s objectives.
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Assists as the as the Managed Care lead for company’s sales and marketing teams.
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Facilitates communication, implementation and maintenance of managed care policies, procedures and objectives.
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Participates in strategy development for the team and lead Health Plan strategy in company meetings.
This list of duties and responsibilities is not all inclusive and may be expanded to include other duties and responsibilities, as deemed necessary.
REQUIREMENTS
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Bachelor’s degree in Business or related field.
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7+ Years of experience in account management and healthcare sales.
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Experience with CPT-Code reimbursement Previous experience with independent home office work and travel.
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Presentation skills.
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Previous contract review, negotiation.
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Knowledge of CMS, and third-party payor requirements, prior authorizations, claims adjudication, medical policy review.
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Proficient in working with Microsoft Office, specifically MS Excel and Power Point.
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Must be able to handle a wide work variety and work in a fast-paced environment.
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Must be a detail-oriented, organized, self-starter, and have an ability to prioritize workload.
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Ability to analyse and interpret data and solve practical problems.