AVP of Payor Relations - Home Health and Hospice (Remote)

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　　Job Details

　　Requisition #:

　　193538

　　Location:

　　Atlanta, GA 30304

　　Category:

　　Business Operations

　　Position Details

　　Position Overview

　　The AVP, Payer Relations is responsible for managing and developing the payer relationships of Aveanna Healthcare in compliance with all regulatory requirements. The priority of this role is to identify and evaluate strategic opportunities within the private duty nursing, home care, therapy, and ABA industries and capitalize on new sources of revenue related to third party payers including managed care and commercial insurance relationships, all in accordance with the core values of Aveanna Healthcare

　　Essential Job Functions

　　Develop relationships within local, regional, national commercial/managed care organizations and payers.

　　Leads in developing payer-specific contracting, retention and improvement plans.

　　Exercises general day- to-day supervision over payer relations in contract negotiations with third party payers and managed care providers to develop new sources of revenue.

　　Utilize current relationships to enhance and develop new business line revenue.

　　Lead negotiator for major health plans and other third party payers’ contract negotiations.

　　Lead, participate, add value, and successfully solve an array of strategic and business challenges related to managed care and reimbursement.

　　Responsible for developing strategies and orchestrating tactical plans for all managed care contracting activities.

　　Responsible for the successful negotiation and management of financially beneficial commercial and managed care relationships, either directly or indirectly through collaboration with sales and operations.

　　Collaborate with PDN/Therapy/ABA leadership and clinical team to develop data-driven strategy that demonstrates the value-added to payer networks.

　　Align with Sales and PDN partners to leverage relationships to obtain DME agreements or negotiate better rates.

　　Work with PDN/Therapy/ABA Senior Leadership to create a defense strategy to ensure that we maintain in-network status with plans that are narrowing their networks.

　　Assist in the development and implementation of strategic and tactical plans and pull-through strategies to maintain and increase Company's revenue.

　　Assist SVP, Payer and Government Relations and VP, National Director, Government Relations in the development of strategic relationships with key associations and organizations regionally and locally and participate in their activities as required.

　　Collaborate with sales and operations leadership and the clinical team to develop data-driven strategy that demonstrates the value-added to payer networks.

　　Align with Sales and PDN partners to leverage relationships to obtain new agreements or negotiate better rates.

　　Work with Senior Leadership to create a defense strategy to ensure that we maintain in-network status with plans that are narrowing their networks.

　　Continually analyze competitive landscape and environment within assigned accounts to determine trends and provide customer feedback to leadership.

　　Other pertinent duties as assigned.

　　Continually analyze competitive landscape and environment within assigned accounts to determine trends and provide customer feedback to leadership.

　　Other Skills/Abilities

　　Ability to engage in a consultative selling process that overcomes objections and indifferences while connecting client needs with the company's capabilities

　　Comfortable selling at the executive level (CEO, COO, CFO, EVP, SVP)

　　Keen understanding of managed care and health plan operations including reimbursement

　　Ability to leverage established relationships and experience to gain momentum early on.

　　Ability to work independently, communicate proactively, manage multiple projects and prioritize daily tasks while managing critical deadlines

　　Ability to maintain an outstanding level of market, customer, distribution and product knowledge necessary to accomplish sales and marketing objectives

　　Excellent negotiation, presentation, influencing and customer service skills

　　Outstanding strategic sales account planning skills

　　Superior listening and problem solving skills

　　Ability to handle sensitive information and maintain a very high level of confidentiality

　　Demonstrate consistent closing abilities throughout the sales cycle

　　Possess a very positive attitude and an understanding of the dynamics involved with organizational growth and change

　　75% travel required as face to face time is essential to build the solid relationships as needed.

　　Ability to act within Aveanna’s Vision and Values.

　　Qualifications

　　Bachelor's Degree required; Master's degree in Healthcare Care Administration or Business preferred.

　　At least five (5) years experience in a managed care environment with direct payer contracting experience.

　　Physical Requirements

　　Must be able to speak, write, read and understand English

　　Frequent lifting, caring, pushing and pulling of up to 25 pounds

　　Occasional lifting, caring, pushing and pulling of up to 50 pounds

　　Prolonged walking, standing, bending, kneeling, reaching, twisting

　　Must be able to sit and climb stairs

　　Must have visual and hearing acuity

　　Environment

　　Performs duties in an office environment during agency operating hours

　　Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions

　　Other Duties

　　Please note 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.

　　Vaccination Requirements

　　As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

　　As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

　　Notice for Job Applicants Residing in California (https://www.aveanna.com/CCPANotice.html)

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