VP, Payor Strategy – Relations

Role Overview

• Develop and implement comprehensive payor strategies that align with Fresenius Medical Care's business goals across both fee-for-service and value-based care models
• Establish and maintain strong relationships with key payor organizations to explore partnership opportunities, enhance collaboration, and implement innovative strategies to improve revenue and margin
• Evaluate new/enhanced payor revenue opportunities through alternative revenue streams
• Continually monitor and evaluate federal and state healthcare regulations and Medicare reimbursement policies and methodologies with potential impact on private payor contracts, reimbursement models, and relationships
• Represent the organization in industry forums and payer/provider advisory boards to influence reimbursement policy and proactively evaluate and prepare for industry and market shifts impacting payor reimbursement
• In partnership with Managed Care and Revenue Strategy & Integrity leadership, develop key payor negotiation strategies to secure and enforce favorable payor contract terms, including reimbursement rates and contractual provisions, to maximize revenue growth
• Collaborate with Insurance Coordination and Revenue Cycle leadership to influence favorable payor mix through patient advocacy and admissions strategies
• Oversee the analysis of payor contract performance, payor reimbursement trends, payor forecast models, and financial outcomes to identify opportunities for revenue and margin improvement and inform strategic decisions
• Build and lead a team of Payor Strategy & Relations professionals in fostering a collaborative environment to achieve departmental and organizational objectives
• Work closely with internal departments, including Managed Care, Revenue Strategy & Integrity, Insurance Coordination, Operations, Revenue Cycle, and Finance to ensure alignment and effective execution of payor-related initiatives
• Perform additional responsibilities as assigned to support the company's overall success.

Requirements

• Bachelor’s degree in business administration, Finance, Healthcare Management, or a related field required; master’s degree (MBA, MHA, MPH, or related) strongly preferred
• Minimum of 15 years of progressive leadership experience in healthcare payor/provider strategy, payor/provider contracting, healthcare finance, healthcare revenue cycle, reimbursement, with at least 5 years in a leadership role
• In-depth understanding of private and government payor systems, reimbursement methodologies, and healthcare regulations and polices
• Strong negotiation, analytical, and interpersonal skills, with the ability to develop strategic initiatives and lead a team effectively
• Demonstrated success in driving enterprise-level strategic planning and execution across multidisciplinary teams
• Expertise in negotiation strategy development and implementation of best-in-class revenue improvement initiatives
• Advanced analytical skills with experience in using business intelligence tools and financial modeling to drive improved revenue outcomes
• Exceptional executive presence with excellent communication, negotiation, and stakeholder engagement abilities
• Experience working within or alongside large, national healthcare systems or provider networks is highly desirable.

Benefits

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
• Drug-free workplace in accordance with applicable federal and state laws