Payor Strategy Manager

Job Description

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.

The Payor Strategy Specialist is responsible for partnering with Payors across assigned geography and/or accounts: Medicare, Medicaid, Commercial, Military, Managed Care Organizations, Accountable Care Organizations and more.

Location: Remote

Schedule: Full time (40 hrs) - Monday-Friday. Normal business hours.

Target Pay Range: $130,000.00-$150,000.00/year (exempt) - Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Benefits:

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

You can expect to:

• Execute payor strategy, and business plan to contribute to departmental sales goals.
• Initiate, negotiate, renegotiate and close payout contracts, letters of agreement and contract revisions, as prioritized by claims volume, market trends and/or corporate leadership.
• Initiate 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.
• Understand and execute 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.

Qualities we're looking for:

• Bachelor's degree preferred
• 3+ 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 escalate 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

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.