Senior Payor Strategy Specialist

Bicycle Health; United States; Remote; USD 85,000 - 105,000; Full time

Benefits offered by this job

PTO and holidays

Parental leave

Medical/Dental/Vision insurance (100%)

STD & LTD

401k

Remote work stipend

Job summary

Bicycle Health is a telemedicine group that specializes in the evidence-based treatment of individuals with Opioid Use Disorder using buprenorphine. We’ve grown our clinical staff of medical providers caring for patients across 32 states, and we employ a large ancillary staff for support with technologic and administrative needs, clinical and behavioral support, and care coordination.

Our innovative model has achieved clinical outcomes that exceed expectations for standard-of-care in-person

Qualifications

• Bachelor’s degree preferred.
• 5+ years of payor strategy or business development experience.
• Experience selling value-based products to regional payors.
• Ability to review contracts and negotiate favorable terms.
• Familiarity with Revenue Cycle Management and contract implementation.
• Strong communication, collaboration, and problem-solving skills.

Responsibilities

• Formulate and execute comprehensive payor strategies and business plans to drive departmental sales goals.
• End-to-end lifecycle - initiating, negotiating, renegotiating and executing complex payout contracts, letters of agreement and contract revisions.
• Establish, scale and nurture regional and strategic account relationships at multiple levels with the partner.
• Maintain a strong focus on helping the market understand Bicycle Health’s unique value proposition.
• Utilize financial modeling to assess the sustainability of payor rate structures.
• Contract with new partners and negotiate sustainable rate schedules implementing bundled or value-based pricing strategies.
• Ensure contract language is consistent with Bicycle Health’s interests.
• Implement Payor Contracts to maximize revenue and pull-through opportunities.
• Expand existing relationships to increase account value through renegotiation and go-to-market expansion.
• Complete designated profiles and documentation on new deals; communicate progress in forecasts.
• Become a subject matter expert regarding payor contracts and strategic account management.
• Collaborate with Revenue Cycle Management, Licensing and Credentialing, Compliance, Marketing, Operations, Enrollment and stakeholders for contract alignment.
• Regular attendance and other duties as assigned.

Skills

Payor strategy

Contract negotiation

Relationship management

Communication

CRM proficiency

Strategic sales

Education

Bachelor’s degree preferred

Tools

CRM software

Job description

The Opioid Epidemic is a public health crisis with a highly effective but underutilized clinical intervention - millions of Americans are physically dependent on Opioids but only 10% of those likely to have OUD actually access treatment. Bicycle Health addresses this gap by maximizing accessibility, affordability, and overall quality of care by enabling highly qualified clinicians to reach patients broadly and efficiently through our online platform.

JOB OVERVIEW:

The Senior Payor Strategy Specialist is responsible for driving the expansion and sustainability of our strategic payor footprint across assigned geography and/or accounts: Medicare, Medicaid, Commercial, Military, Managed Care Organizations (MCOs), Accountable Care Organizations (ACOs) and more.

Target Pay Range: $85,000-$105,000 - Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Benefits:

• 3 Weeks PTO + 8.5 days of additional sick time + 10 paid holidays
• Paid parental leave
• 100% Employer Paid Medical, Dental, and Vision Insurance
• Employer Paid STD & LTD
• 401k
• $50 monthly Remote Work Stipend

RESPONSIBILITIES:

• Formulate and execute comprehensive payor strategies and business plans to drive departmental sales goals.
• End-to-end lifecycle - initiating, negotiating, renegotiating and executing complex payout contracts, letters of agreement and contract revisions, as prioritized by claims volume, market trends and/or corporate leadership.
• Establish, scale and nurture regional and strategic account relationships at multiple levels with the partner.
• Maintain a strong focus on helping the market understand Bicycle Health’s unique value proposition.
• Utilize financial modeling to assess the sustainability of Payors rate structure and/or proposed rates for new accounts or account rate changes.
• Contract with new partners and negotiate sustainable rate schedules implementing bundled or value-based pricing strategies whenever possible.
• Ensure contract language is consistent with Bicycle Health’s interests.
• Implement Payor Contracts to maximize potential revenue and pull through opportunities.
• Expand upon existing relationships to increase the value of the account by renegotiating rates, introducing value-based models, and/or expanding go-to-market efforts.
• Complete all designated profiles and documentation on new deals to be reviewed.
• Document progress in sales support applications and communicate consistently regarding sales forecasting.
• Become a subject matter expert regarding payor contract implementation and strategic account management for assigned accounts.
• Partner with the internal team included Revenue Cycle Management, Licensing and Credentialing, Compliance, Marketing, Operations, Enrollment and all other stakeholders to ensure contract alignment and execution.
• Regular and predictable attendance is expected.
• All other duties as assigned.

QUALIFICATIONS:

• Bachelor’s degree preferred
• 5+ years of business development experience in the payor sector. Value-based care experience is a plus.
• Existing relationships with, and experience selling value-based products/services to Regional Payors.
• Ability to review contracts, respond with readiness, and negotiate win-win deals with Payors.
• Prior experience working with Revenue Cycle Management teams and contract implementation.
• Strong communicator who can proactively identify potential challenges and think creatively about solutions.
• Team player that is highly collaborative, goal-oriented, and confident.
• Ability to receive feedback and take constructive steps to improve skill sets as needed in a fluid and changing environment.
• Self-starter who thrives when given autonomy but able to escal as appropriate and is comfortable with ambiguity.
• Skilled at documentation and familiar with use of a CRM, attention to details.
• Able to manage multiple tasks simultaneously and effectively.
• Possesses prioritization skills to meet long-term and short -term goals
• Consistent access to a private work environment with high speed internet and professionally appropriate surroundings for frequent video conferencing and a workstation setup conducive to remote work needs.

This is a full-time (40hrs per week) remote position.

#LIRemote #zr Mid-Senior Level -

About Bicycle Health:

Bicycle Health is a telemedicine group that specializes in the evidence-based treatment of individuals with Opioid Use Disorder using buprenorphine. We’ve grown our clinical staff of medical providers caring for patients, across 32 states, and we employ a large ancillary staff for support with technologic and administrative needs, clinical and behavioral support, and care coordination. Our innovative model has achieved clinical outcomes that exceed expectations for standard-of-care in-person treatment nationally. Our mission is to increase access to high quality, affordable, convenient and confidential Opioid Use Disorder treatment for all.

Bicycle Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or any other basis forbidden under federal, state, or local law.