The Aspen Group (TAG) is one of the largest and most trusted retail healthcare business support organizations in the U.S. and has supported over 20,000 healthcare professionals and team members with close to 1,500 health and wellness offices across 48 states in four distinct categories: dental care, urgent care, medical aesthetics, and animal health. Working in partnership with independent practice owners and clinicians, the team is united by a single purpose: to prove that healthcare can be better and smarter for everyone. TAG provides a comprehensive suite of centralized business support services that power the impact of five consumer-facing businesses: Aspen Dental, ClearChoice Dental Implant Centers, WellNow Urgent Care, Chapter Aesthetic Studio, and AZPetVet. Each brand has access to a deep community of experts, tools and resources to grow their practices, and an unwavering commitment to delivering high-quality consumer healthcare experiences at scale. Combined, the companies serve more than 30,000 patients a day and more than 8 million patients each year.
As a reflection of our current needs, we have an exciting opportunity to join our Payor Strategy team as Senior Manager, Payor Strategy. The Senior Manager of Payor Strategy plays a vital role within our Payor Strategy Team. The successful candidate will report to the Vice President, Payor Strategy.
Essential Responsibilities
Responsible for working with Vice President + Senior Vice President of Payor Strategy on managing the contract portfolio for Aspen Dental. This includes pursuing and preparing for renewals, assisting in the implementation and execution of new contracts, as well as all necessary contractual amendments, changes, and renewals. Assists in managing the relationship with plans and finding solutions for operational challenges they face.
Essential Functions
- Develops and maintains effective working relationships with insurance company and managed care company personnel responsible for contracting with healthcare providers.
- Manage the implementation, execution, and communication of contracts throughout organization.
- Act as an expert resource on escalated contractual issues in addition to resolution of high-level compliance and customer-related concerns.
- Responsible for managing payor contract portfolios on a regular basis including monitoring, tracking, and touchpoints.
- Support ongoing payor negotiations including language, rates, amendments, etc. as needed with leadership.
- Monitor contract performance and other provisions to assure compliance, identify problem areas, and resolve disputes.
- This position is responsible for managing and completing major departmental projects including recommending project plans and recommending resource allocations.
- Resolve escalated contract issues generated by operational department heads.
- Draft and communicate customer announcements for newly executed, terminated, or revised/updated contracts and payor industry news.
- Work collaboratively with payors and Aspen Department Leadership (i.e Legal/Compliance, Finance, Centralized Billing, and IT) on strategic business development efforts to ensure geographic maximization, plan and service types, and optimal reimbursement rates.
- Other duties as assigned.
Experience
- Bachelor's degree
- 6-8 years of progressively responsible management or supervisory level managed care contracting experience in a payor or health care setting with at least five (5) of these years' experience in a medium to large health system.
- Broad knowledge of healthcare insurance, physician billing and reimbursement, administration, systems, practices and principles, (i.e. Medicaid, Medicare, Medicare Advantage, and Commercial.)
- Knowledge and ability to effectively utilize negotiation techniques and practices to effectively advocate for providers.
- Excellent verbal & written communications
- Excellent time management, prioritization, and organizational skills a must.
- Detail oriented with a strong level of analytical, and problem-solving skills
- Proficient use of Microsoft Office Suite.
Salary: $115-130k with bonus opportunity
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