Payor Strategy Lead

Summary

Join Journey Clinical, a healthtech company transforming mental health care, as their Payor Strategy Lead. You will spearhead the development and execution of strategies to expand access to high-quality behavioral health services. This pivotal role involves leading contract negotiations with national and local insurers, creating tailored partnership proposals, and analyzing financial impacts of reimbursement rates. You will also manage relationships with health plans, identify key decision-makers, and analyze data to optimize reimbursement strategies. Furthermore, you will communicate updates to internal stakeholders and advise leadership on payor mix and strategic opportunities. This position requires a strong background in payor relations and proven success in contract negotiations within the behavioral health space.

Requirements

• 5-8 years in payor relations and strategy
• Proven success in negotiating contracts and rate improvements upon renewals
• Experience in the behavioral health space

Responsibilities

• Lead contract negotiations and renegotiations, securing favorable rates and terms while ensuring compliance with regulatory standards
• Create tailored partnership proposals that address the unique needs of each health plan and prioritize improved patient access and care quality
• Model and analyze the financial impact of new and renegotiated reimbursement rates to inform business decisions
• Expand and strengthen partnerships with existing and prospective health plans to increase access to behavioral health care
• Identify, engage, and cultivate relationships with key decision-makers at target payors to unlock new collaboration opportunities
• Analyze data related to payor policies, reimbursement rates, and market trends to optimize reimbursement strategies
• Track and report on key payor performance metrics, including reimbursement analysis, denial rates, and other KPIs, in partnership with Revenue Cycle Management
• Communicate updates on payor trends, contract changes, and regulatory developments to internal stakeholders
• Advise leadership on payor mix, market positioning, and strategic opportunities to support organizational growth objectives