ZirMed is a nationally recognized leader in delivering revenue cycle management solutions for healthcare providers. Our innovative, online solutions simplify the complexities of patient engagement, claims filing, payment tracking and patient collections. We serve more than 125,000 providers and are ranked among Inc. Magazine’s 500 fastest growing and Healthcare Informatics Top 100 companies.
The Manager of Payer Solutions is an experienced healthcare professional with direct impact to the financial success of ZirMed. This highly motivated individual will have primary focus externally; building relationships and contracting with payer organizations to expand ZirMed’s network of direct relationships. This role also manages the Payer Account Management Team, which is responsible for maintaining relationships, creating and implementing payer-specific performance plans and contracting to continually increase services and transactions available to ZirMed Providers.
Create marketing/contracting plan to increase network of direct payer connections
Analyze market data to identify trends and opportunities
Proactively cultivate business relationships with key contacts and decision makers at payer organizations, clearinghouses and other industry organizations
Negotiate, review and complete contracts with payer organizations
Evaluate relationships and connections to improve financial margin
Manage the payer account management team
Evaluate the performance of each contracted relationship, ensuring compliance with terms and expected thresholds are met
Engage internal stakeholders in evaluating operational impact and performance
Develop and maintain structured operational review meetings with tier 1 payers
Create and implement payer-specific performance improvement plans
Maintain contractual records and documentation
Monitor connection implementation for accuracy and cycle time
Monitor transaction compliance (volumes, milestones, invoicing, etc)
Monitor case resolution performance (volumes, closure rates, etc)
Coordinate initiatives related to industry and legislative efforts
Coordinate promotional opportunities with Marketing, Sales and Service areas.
Desired Experience and Skills
Post graduate degree or commensurate healthcare experience required
5+ years experience with healthcare payer/provider relations, EDI transactions, payer product/technology, industry consultation or contracting required.
Experience managing consultative, influencing and/or sales teams
Demonstrated understanding of the value and priority payer organizations seek
Self-starter interested in controlling ones own success
Experience building and managing relationships at all levels of an organization
Exceptional written and verbal communication skills
Ability to evaluate complex scenarios and communicate them clearly
Ability to create and manage process and procedures independently
Physical demands and work environment: The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of their positions.
While performing the duties of this job, the employee must be able to remain in a stationary position for more than 75% of the time; constantly operate a computer key board or other office equipment; frequently observe, detect, recognize, identify and discern information from both close and long distances; frequently assess, judge, communicate, convey and exchange information with others. The employee must occasionally move items weighing up to 15 pounds.
Work environment: While performing the duties of this job, the employee is exposed to ambient room temperatures, lighting and traditional office equipment as found in a typical office environment. The noise level in the work environment is usually minimal.
The employee is expected to adhere to all company policies.
City of Louisville, KY - 12 months ago