SUMMARY 

*Remote opportunity*

This position is responsible for proactively developing and executing Managed Vision Care contract strategies and tactics in collaboration with senior management; managing all payor contracts; familiarity with different types of payors; negotiating rates and other contract terms; financial analysis; liaison with payors; working in a cross-functional / departmental role with other areas of the organization; distributing contract and policy updates; resolving payment disputes and issues; building and developing a team responsible for executing, monitoring and reporting on the full range of contracting strategies; and other duties as required.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Establish and manage positive managed vision care payor and other third-party relationships 
• Research and monitor changes in the payor environment (local, regional, national, CMS) to develop informed strategies
• Develop and maintain a managed vision workplan tied to organizational and operational priorities
• Model contract proposals, draft contract terms, review and recommend strategy, negotiate, and finalize new/renewed/renegotiated contracts
• Provide managed vision subject matter expertise and educational tools to company operations and revenue cycle team regarding participation in payor programs and contracts
• Evaluate contract performance to understand variances vs expected outcomes, recommend interventions and takes appropriate action
• Monitor and maintain accurate complete payor files for timely and efficient reference and claim processing
• Perform all duties while maintaining compliance with all appropriate regulatory requirements including HIPAA
• Lead and develop a team responsible for executing, monitoring and reporting on the company's managed vision contracting strategies
• Supervise, evaluate and develop employees through coaching, mentoring, and formal/on the job training and development opportunities.
• Launching institutionalized communication channels to other affected parts of the organization (e.g., Finance, RCM, Operations, etc.) to ensure relevant contract terms and payor specifics are known across the organization

QUALIFICATIONS

• 8+ years leading managed vision payor contracting or managed vision network development for a provider organization
• Experience with strategy to drive improvements in payor access, quality and efficiency
•  Experience building and developing a team - i.e., standing up the appropriate junior level resourcing, developing overarching strategy and direction, institutionalizing workplans, KPIs and goals
• Unparalleled attention to detail and organizational skills - i.e., ability to develop clear and coherent organization structure for filing contracts and aligning fee schedules, ensuring negotiations and applications contain all relevant details
• Ability to create processes, tools and policies from the start, with minimal foundation in place - i.e., centralized trackers and reference documents, state / payor specific processes
• Experience with various national, state and government payors
•  Strong communication skills: ability to synthesize relevant details to other parts of the organization, as well as keep an open and transparent line of communication to the Executive team
• Collaborative spirit - a strong orientation to working with other parts of the organization, and synthesizing input from the Executive team in developing processes and strategies
•  Demonstrate an unparalleled degree of trust given this role has a high degree of externally facing interaction with payors and other third parties
• Highest ethical and professional standards