The Vice President of Payor Relations oversees all aspects related to value-based and fee-for-service payor contracts. This includes development of contracting strategies and negotiation for all clinical services provided by the members of MaineHealth. Payor contracts include commercial insurance companies, employer sponsored health plans, Medicare advantage plans, Medicaid managed care plans, other governmental payors, and Worker’s Compensation programs. Collaboration with the MaineHealth ACO is required for several payor relationships and contracts. The Vice President will also serve as the Executive Director of the Maine Heart Center, a separately governed joint venture of MaineHealth that contracts for bundled cardiac services. The Executive Director of the Maine Heart Center oversees the staff of that organization and works closely with the President of the Board of Directors of the Maine Heart Center.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
Bachelor’s degree required. Master’s degree in Accounting, Finance, Business Administration, health care or related field or a law degree strongly preferred.
Minimum 10+ years of progressively responsible work experience with at least five in healthcare.
Demonstrated understanding of all aspects of negotiations, contacting and reimbursement, and relevant regulatory and compliance issues.
Excellent communication skills, both verbal and written.
Outstanding negotiation skills.
Ability to work with people at all levels of the organization.
Ability to maintain professionalism in difficult and sensitive conversations where stakeholders may disagree.
Excellent strategic thinking skills.
Outstanding organizational and analytical skills.
Knowledge and understanding of financial implications of various contracting structures.
Demonstrated knowledge of managed care and value-based care principles.
Knowledge and experience with risk-based contracting structures and of contract language.
Knowledge of different healthcare rate structures and payment methodologies.
Develops and maintains system for contract evaluation, implementation and ongoing performance monitoring.