Regional Manager, Payor Relations at Concentra

Newark, New Jersey, United States -

Full Time

Start Date

Immediate

Expiry Date

11 Feb, 26

Salary

110000.0

Posted On

13 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Customer Service, Sales Management, Healthcare Knowledge, Negotiation, Strategic Selling, Problem Solving, Communication, Analytical Skills, Team Management, Relationship Building, Market Analysis, Presentation Skills, Compliance Knowledge, Financial Analysis, Resource Allocation, Critical Thinking

Industry

Hospitals and Health Care

Description

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 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 team’s 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 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 • 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 job's essential functions successfully. In 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: Bachelor’s Degree Major: Business Administration, Marketing or related field Degree must be from an accredited college or university. 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 7 years • Customarily has at least seven or more years of experience in healthcare, P&C Insurance, Worker's 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 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 • 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. *This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management* Concentra is an Equal Opportunity Employer, including disability/veterans.

Responsibilities

The Regional Manager, Payor Relations develops and manages relationships with assigned payer accounts, focusing on revenue growth and customer satisfaction. Responsibilities include territory management, client consultation, and implementing sales strategies.