Regional Manager, Payor Relations

Overview

Concentra is recognized as the nations leading occupational health care company.

With more than 40 years of experience Concentra is dedicated to our mission to improve the health of Americas 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 Manager Payor Relations develops manages and maintains relationship to assigned payer accounts for a book of business with annual revenue up to and exceeding $50MM. Manages self as well as teams implementation of regional 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 within the state or region.

Responsibilities

Develop and manage self and the teams 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 Concentras 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

Implement Regional 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.

Participate in continuing education programs on company products services sales training and industry compliance and assist with continuing education programs for client

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 of Sales periodic outcome pipeline forecasting revenue performance (growth) statistical reports and issue resolution; Meeting or exceeding 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 assists with coordination of payer audits by working with Central Billing Office (CBO) to ensure appropriate reimbursement for services rendered

Meet with regional leadership in various areas to review quality of care

While performing the duties of this job the employee is frequently sitting and occasionally standing and walking. May occasionally utilize hands and fingers to perform job-related tasks. Occasional climbing and repetitive motion in work performance. The ability to hear and understand with clarity detect sound and have conversations with staff customers management etc. The hearing is within the acceptable range for various communications such as telephone in-person virtual (electronic) etc. Normal or corrected vision to acceptable levels for office work. The ability to lift / carry up to 20 pounds. Work is performed primarily in an office / field (remote) environment. This position requires frequent communication with clients staff management and customers. The position requires flexibility in working hours. Must be able to resolve conflicts as they arise effectively. The mental demands described here represent those that an employee must meet to perform this jobs essential functions this position the employee may have imposed pressure on a routine basis to meet various deadlines. Based on the nature of the job and healthcare industry some stressful and unpredictable situations require a person to address them with care and sensitivity as company policies and regulations require. Employees are more than likely to access confidential and sensitive information and must handle these documents with extreme care.

Travel : Occasional overnight travel (up to 20%) by land or air is required of employee in this position. While traveling the employee may encounter varying weather conditions road and walking surfaces and will need to adjust to those conditions (i.e. inclement weather slippery surfaces wet surfaces uneven surfaces humid cold or hot temperatures etc.). Also while traveling the employee will need to adjust to the physical demands that may include lifting to place luggage in overhead bin(s) standing in line(s) walking sitting for unknown periods of time and other physical demands that traveling may impose on a person.

Qualifications

Education Level : Bachelors Degree Major : Business Administration Marketing or related field Degree must be from an accredited college or university.

Education Details :

Bachelors 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

7 years

Customarily has at least seven or more years of experience in healthcare P&C Insurance Workers Compensation and / or 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

Workers Compensation industry consisting of Carriers Third Party Administrators Managed Care

Organizations Nurse Triage & Specialty Networks

Thorough insight into Key industry players and organizations

Working knowledge of Workers 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

Thorough understanding of strategic and conceptual selling or other formal sales training approach

Experienced in the use of CRM

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

High Energy

Oral comprehension and expression

Written comprehension and expression

Problem sensitivity

Additional Data

Employee Benefits

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

This position is eligible to earn a base compensation up to $110K additional quarterly and annual incentive potential on top of the base 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.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. Please contact us to request accommodation if required.

Concentra is an Equal Opportunity Employer including disability / veterans.

Required Experience :

Manager

Key Skills

Campaigns,Invasive Cardiology,Accounting Tally,DCS,Drafting,Activex

Employment Type : Unclear

Experience : years

Vacancy : 1