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Market Access Leader

Midi

Midi

Remote
Posted on Friday, May 31, 2024

We are seeking a highly skilled and experienced Market Access leader to join our team. In this role, you will be responsible for negotiating payor contracts with insurance companies and employer-sponsored health plans, with a specific focus on the women’s health/telehealth space. This role will work diplomatically with the internal Commercial team as well as externally with employer clients and payors. You will be tasked with maintaining and nurturing strong relationships with payor partners to ensure mutual success and ongoing collaboration.

Key Responsibilities:

  • Negotiate payor contracts with insurance companies and employer-sponsored health plans, primarily focusing on complex contracts, reimbursement models, or those requiring strategic planning
  • Develop and execute strategic plans to achieve favorable contract terms and reimbursement rates that align with the company's objectives, addressing any barriers to market access
  • Collaborate with employers and insurance companies to develop and implement customized provider networks tailored to meet the specific needs and preferences of covered populations, ensuring optimal access to high-quality healthcare services
  • Lead negotiations with payors to establish favorable contract terms, reimbursement rates, and network agreements, while strategically aligning with employer objectives and benefit design strategies to enhance employee satisfaction and healthcare outcomes
  • Collaborate cross-functionally with internal stakeholders, including commercial, finance, credentialing, and operations, to ensure alignment on contract terms and requirements
  • Represent the company in meetings with potential employer clients to negotiate payor contracts, reimbursement models, and establish strategic partnerships
  • Analyze market trends, competitor strategies, and regulatory changes to inform contract negotiations and optimize revenue opportunities.
  • Serve as the primary point of contact for payor partners, addressing inquiries, resolving issues, and fostering positive relationships
  • Monitor contract performance and financial metrics, identifying opportunities for rate re-negotiations or reimbursement models
  • Analyze and interpret reimbursement policies and trends to inform pricing and market access decisions
  • Stay abreast of industry developments, emerging trends, and best practices in payor contracting and relations within the digital healthcare space

Qualifications:

  • Bachelor's degree in Business Administration, Healthcare Administration, or a related field (Master's degree preferred)
  • Minimum five years of experience in payor contracting and relations, with a strong emphasis on negotiating contracts, employer benefit design, and/or custom networks
  • Proven track record of successfully negotiating and managing payor contracts, achieving favorable terms and driving revenue growth
  • Deep understanding of healthcare reimbursement methodologies, fee schedules, and regulatory requirements
  • Excellent communication, negotiation, and relationship-building skills, with the ability to effectively interface with internal and external stakeholders
  • Strong analytical and problem-solving abilities, with a data-driven approach to decision-making
  • Knowledge of women’s health and telehealth industry trends is a plus