Regional Director Payor Relations

5 days ago


Parsippany, New Jersey, United States Concentra Full time $143,000 - $198,000
Overview

Concentra is recognized as the nation's leading occupational health care company.With more than 40 years of experience, Concentra is dedicated to our mission to improve the health of America's workforce, one patient at a time. With a wide range of services and proactive approaches to care, Concentra colleagues provide exceptional service to employers and exceptional care to their employees.

The Regional Director, Payor Relations develops, manages and maintains relationship to assigned payer accounts for a book of business with annual revenue up to and exceeding $100MM. Manages self as well as team's implementation of regional and national sales and account management of current and future product offerings to assigned clients consisting of (and not limited to) the following: horizontal selling (growth), lead generation, developing and increasing direction of care, building brand awareness, service and issue resolution, implementing and executing uniquely defined mutual strategies, stewardship reporting, client consultation and overall customer satisfaction of all assigned accounts.

Responsibilities

Develop and manage self and the team's successful relationships with assigned group of payor accounts, consisting of Insurance Carriers, Third Party Administrators, Managed Care/Managed Provider Networks, Professional Organizations, PBM, and Specialty Networks


• Responsible for expanded knowledge of all of Concentra's product offerings and the sales and execution of such, focusing on growing the clinic penetration and market share for zone exceeding assigned revenue growth for each assigned account
• Participate in continuing education programs on company products, services, sales training and industry compliance
• Implement Regional, National and Integrated Sales strategies and programs into the local market
• Maintain productivity to meet and exceed the budgeted incremental revenue expectations
• Conduct, lead and sponsor external presentations/stewardship/meetings/strategy meetings
• Territory management which includes payor office visits and meeting with claims manager, supervisors, adjusters and nurse case managers
• Participate in goal setting strategy sessions monthly and quarterly which are specific to mutual accounts between payer and division

Participate with internal teams to assist in the development of customer specific customer service protocol and strategies. Assist in improving services delivered at the Center/Centers.
• Continually evaluate the need for needs assessments, sales call/product presentations, sales proposals and expansion, rate negotiation, providers and benefit comparisons, coordination of installation and implementation of services sold
• Interface with internal departments to assist with developing and setting account strategy, managing contracting and price increases and understanding and controlling total profitability of assigned account(s)
• Manage personal and Payor Director reporting through C4 activity
• Maintain and submit to Vice President/SVP Sales of Payer Relations periodic outcome, pipeline forecasting, revenue performance (growth), statistical reports and issue resolution
• Meet or exceed periodic growth goals and product expansion established with supervisor
• Identify problems with assigned/unassigned payor/TPA/network accounts and facilitate timely solutions with specific company business unit. Serve as main contact between payer issues and division resolution
• Develop payor sales lead efforts with zone and regional sales team and other zone disciplines in order to meet or exceed growth goals
• Responsible for review and analysis of the financial performance of assigned territories to sales, area and zone management
• Participate in and assist with continuing education programs for client
• Participate in and assists with coordination of payer audits by working with Central Billing Office (CBO) to ensure appropriate reimbursement for services rendered
• Meet with regional and corporate leadership in various areas to review quality of care
• Act as primary client facing relationship to assigned payors

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Qualifications

Education Details:
• Bachelor's degree in Business Administration, Marketing or related field from an accredited college, or combination of education and related-work experience and training
• In lieu of an undergraduate degree, the ratio is 1:1 meaning one year of college is equal to one year of directly related work experience and vice versa


• Customarily has at least the following experience: 7 years
• Customarily has at least seven or more years of experience in healthcare, P&C Insurance, Worker's Compensation, and Managed Care


• Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
• Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
• Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
• The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies

Knowledge
• Workers Compensation industry consisting of Carriers, Third Party Administrators, Managed Care Organizations, Nurse Triage & Specialty Networks
• Through insight into Key industry players and organizations
• Working knowledge of Worker's Compensation and clinical procedures/processes
• Working knowledge of diagnoses and treatment of occupational injuries
• Working knowledge of Medical Center and procedures
• Experienced with allocation of resources
• Subject matter proficiency in Economics & Accounting and Sales & Marketing
• An awareness of Psychology to support the understanding of human behavior
• Familiarity with applicable laws and government regulations to ensure compliance
• Through understanding of strategic and conceptual selling or other formal sales training approach
• Experienced in the use of CRM
• Skills
• Superior customer service mindset
• Effective Communicator/Articulate
• Strategic, Practical and Conceptual selling
• Superior judgment and decision making
• Systems evaluation
• Critical thinking, analytical
• High level of reading comprehension
• Management of personnel resources


• Results driven
• Deadline orientation
• Abilities
• High Energy
• Oral comprehension and expression
• Written comprehension and expression
• Problem sensitivity

The physical demands 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. While performing the duties of this job, the employee is frequently sitting, standing, and walking. The employee is continuously required to use hands and fingers to feel, handle, or operate PC, office equipment and/or other equipment or tools; will involve continuously flexing, extending and repetitive motion of hands and wrist. The ability to lift/carry up to 10 pounds. The ability to hear and understand with clarity and detect sound, and have conversations with staff, customers, management, etc. Normal or corrected vision to acceptable levels for common office work. Hearing must be in the acceptable range for telephone and in-person contacts. It is necessary to view and type on computer screens for variable periods of time.The mental demands described here are representative of those that must be met by an employee to perform the essential functions of this job successfully. In this position, the employee may have imposed pressure on a routine and frequent basis to meet various deadlines, contact with people in stressful and unpredictable situations and to handle confidential and sensitive information and situations with care.

This position is eligible to earn a base compensation rate in the range of $143,000.00 to $198,000.00 depending on job-related factors as permitted by applicable law, such as level of experience, geographic location where the work is performed, and/or seniority.

Concentra provides equal employment and affirmative action opportunities to applicants and employees without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, pregnancy, protected veteran status, disability, or other protected categories. In addition, Concentra Inc. complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains facilities.

Additional Data
  • 401(k) Retirement Plan with Employer Match
  • Medical, Vision, Prescription, Telehealth, & Dental Plans
  • Life & Disability Insurance
  • Paid Time Off & Extended Illness Days Offered
  • Colleague Referral Bonus Program
  • Tuition Reimbursement
  • Commuter Benefits
  • Dependent Care Spending Account
  • Employee Discounts


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