VP, Payor Strategy & Relations

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• 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.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

• The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable. individuals with disabilities to perform the essential functions.
• This position may require up to 15% travel.

SUPERVISION:

• May be responsible for the direct supervision of various levels of managerial and predominately exempt staff.

EDUCATION AND REQUIRED CREDENTIALS:

• Bachelor’s degree in business administration, Finance, Healthcare Management, or a related field required; master’s degree (MBA, MHA, MPH, or related) strongly preferred.

EXPERIENCE AND SKILLS:

• 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.