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Manager, Payer Contract Strategy

Job ID: 5531992002 Location: Parsippany, NJ Category: Accounting/Finance Date Posted: Sep. 12, 2021
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The Manager will be responsible for a portfolio of health plan agreements and through leading critical negotiations, grow the value of their portfolio, contributing economic and business success to the goal of advancing the delivery of home-based health care services and keeping clients safe at home.  In this role, the Manager will be accountable for the entirety of the contractual relationship with payers in their given geographic territory and portfolio.  Given BAYADA’s growth trajectory and the accelerating contracting activity and financial impact, this role is ideal for a candidate who thrives in a fast-paced environment.  The ability to navigate within a multi-business structure, have a service orientation, and strong character are vital for successful assimilation into our highly collaborative, entrepreneurial culture. 

This will be a hybrid role with time split working remotely and business travel to meet with health plans and team meetings in Parsippany, NJ.

Key responsibilities will include:

  • Establish, maintain, and grow innovative relationships with national and local health plans to create a competitive advantage in the market.
  • Complete all aspects of payer contracting and negotiations, from strategy collaboration through the close of negotiation.
  • Keep stakeholders and leaders informed throughout the negotiation process to ensure their alignment and produce documentation of business decisions around the negotiation.
  • Prepare contracting documents and recommendations for leadership approval.

MINIMUM QUALIFICATIONS:

  1. Exemplifies characteristics of The BAYADA Way: compassion, excellence, and reliability.
  2. Bachelor’s degree required; MBA, MHA, or similar degree preferred.
  3. A minimum of 3-4 years of related experience in health care administration.
  4. Two (2) or more years of negotiating experience (payer/provider contracting, network management, or similar).
  5. Demonstrable track-record of developing and cultivating relationships within healthcare, including health plans and other entities.
  6. Working knowledge of Medicare and managed Medicaid reimbursement and health plan payment models.
  7. Strong collaboration skills with a broad group of internal and external stakeholders and business partners
  8. Excellent written and verbal communication skills
  9. Ability to thrive in a fast-paced and cross-functional environment.
  10. Excellent analytical, problem solving and organizational skills a must.
  11. Advanced Excel and PowerPoint skills.
  12. Demonstrated record of goal achievement and exceeding performance standards.
  13. Candidate should reside in EST or CST

PRIMARY RESPONSIBILITIES:

  1. Demonstrate and communicate the core values of BAYADA Home Health Care and The BAYADA Way.
  2. Negotiates optimal fee for service contracts with payers across commercial, Medicare Advantage, and Medicaid products to advance home-based care and encourage client treatment in a safe, lower-cost healthcare setting.
  3. Manage payer agreements effectively across the contracting life cycle.
  4. Collaborates on the development of an effective negotiation strategy for each payer contract, including both fee for service and value-based components.
  5. Cultivate strategic payer relationships and manage those relationships effectively.
  6. Responsibility for the management and growth of a geographic and payer specific portfolio of health plan agreements.
  7. Other duties as assigned.

As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates.

About BAYADA

Founded in 1975 by J. Mark Baiada, BAYADA Home Health Care provides nursing, rehabilitative, therapeutic, hospice, and assistive care services to children, adults, and seniors in the comfort of their homes. BAYADA employs more than 26,000 nurses, home health aides, therapists, medical social workers, and other home health care professionals who serve their communities in 22 states from more than 350 offices, with locations in Germany, India, Ireland, New Zealand, South Korea, Canada, and the UK.

In 2019, Baiada oversaw the company's unprecedented transition to a not-for-profit organization to ensure BAYADA's mission, purpose, and business model would endure, and to help BAYADA realize its vision of helping millions of people worldwide experience a better quality of life at home.

BAYADA Home Health Care, Inc., and its associated entities and joint venture partners, are Equal Opportunity Employers and qualified applicants will not be discriminated against on the basis of race, religion, gender and gender identity, nationality and origin, disability, sexual orientation, age, veteran status, and experiences.

  • I've worked for many other companies, but BAYADA stands out. You definitely won't find another place that appreciates their employees as BAYADA does. Their trainings are the best you'll find in the field, too. Juli K. - Client Services Associate

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