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Philips Payer Relations Manager - Value-Based Contracting, RespirTech (Home-Based) in United States of America - Home Based, Massachusetts

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If you are a Colorado resident and this role is a field-based or remote role, you may be eligible to receive additional information about the compensation and benefits for this role, which we will provide upon request. You may contact 888-367-7223, option 5, for assistance.

In this role, you have the opportunity to:

Develop and maintain an ongoing collaborative relationship with payers based on mutual respect, high-quality outcomes, and patient satisfaction. This role works to continually shape the network landscape by offering objective data and education to all stakeholders in the market. A highly engaged payer relationship and network is critical to ensure patients receive products or services that improve the quality of their lives in a timely manner at an affordable cost for the payer and member.

You are responsible for:

  • Developing value-based contracting relationships with providers/payers and supporting the patient-centric model during new implementations

  • Creating and maintaining a database of pre-implementation metrics

  • Coordinating implementation activities

  • Creating payer-facing educational and summary documents

  • Ensuring all necessary logistics are obtained to support a successful implementation

  • Coordinating onsite requirements for Philips RespirTech colleagues

  • Maintaining positive working relationships with providers/payers to build a high quality, highly receptive network base in mature markets

  • Developing ongoing support materials for payers

  • Working closely with market leaders, medical directors and senior clinical executives within payers to monitor and improve hospital DC referral patterns, par and non-par SNF LOS, and closed record statistics

  • Working closely with payer relations leadership

  • Analyzing data for trends in performance at the market, client, and national levels

  • Supporting new and existing strategic network initiatives and programs

  • Supporting the onboarding of new network colleagues through mentorship

  • Working with internal resources on the development of preferred provider networks

  • Supporting and implementing pay for value programs, as applicable

  • Assisting with contracted network development, as assigned

  • Executing direct contracts with insurance carriers

  • Participating in contract negotiations and contract language review including redlining

You are a part of:

RespirTech, a Philips company, helping people with chronic respiratory conditions breathe easier. That's our passion, our purpose and what we do.

To succeed in this role, you should have the following skills and experience:

  • Bachelor’s degree required

  • Minimum of 5 years of direct value-based contracting experience in a payer-facing or account management role with proven success negotiating directly within the payer at the Medical Director, CFO, and executive level leaders associated with Clinical Management and Claims

  • Minimum of two years successful contracting experience in an ACO (Accountable Care Organization)

  • Data analytics and reporting experience required

  • Experience in managed care, health plan operations in provider contracting, customer service, or provider relations

  • Minimum of 2 years DME/Medical device experience

  • Effective negotiation and influencing skills

  • Detail-oriented

  • Ability to build and foster relationships inside and outside the organization

  • Ability to independently plan, organize and prioritize work

  • Willingness to work toward team objectives

  • Ability to make appropriate organizational determinations in accordance with standards of practice independently and timely

  • Strong brand promotion and management skills

  • Proficiency with Microsoft Office applications

  • Ability to travel up to 75%

In return, we offer you:

This position offers you the opportunity to play a vital role in the success of the Philips RespirTech business. For Sales and Operations professionals, the rewards for working at Philips are vast. You operate at the heart of a worldwide company that continues to transform itself, to become ever more market-driven and consumer-focused.

Why should you join Philips?

Working at Philips is more than a job. It’s a calling to create a healthier society through meaningful work, focused on improving 3 billion lives a year by delivering innovative solutions across the health continuum. Our people experience a variety of unexpected moments when their lives and careers come together in meaningful ways.

To find out more about what it’s like working for Philips at a personal level, visit the Working at Philips page on our career website, where you can read stories from our employee blog. Once there, you can also learn about our recruitment process, or find answers to some of the frequently asked questions.

It is the policy of Philips to provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to race, color, ethnicity, religion, gender, pregnancy/childbirth, age, national origin, sexual orientation, gender identity or expression, disability or perceived disability, genetic information, citizenship, veteran or military status or a person’s relationship or association with a protected veteran, including spouses and other family members, marital or domestic partner status, or any other category protected by federal, state and/or local laws.

As an equal opportunity employer, Philips is committed to a diverse workforce. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veterans' Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants that require accommodation in the job application process may contact 888-367-7223, option 5, for assistance.

Equal Employment and Opportunity Employer/Disabled/Veteran

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