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