Skilled Wound Care provides much-needed bedside surgical care to patients in skilled nursing facilities.
We have been in operation since 2009 and have been growing rapidly since.
We are seeking a motivated and intelligent Payer Contracting Specialist to help our expansion.
Why Wound Care?
Society at large has significantly ignored wounds and ulcers although they are seriously painful for patients and are very devastating to families and patients.
A patient with wounds can be managed better but wounds are a result of poor overall condition and health.
Wounds are not as appealing as other diseases to treat or raise funding for and so this area is generally overlooked, so the need to care for these patients with wounds is even more dire.
Our mission is to help this underserved segment of patients with the best possible care they deserve.
The Payer Contracting Sales & Specialist role
We are searching for a talented, driven and organized Payer Contracting Specialist to handle SWC’s payer negotiations and management functions, policies and projects.
You are results-driven and are able to develop relationships on the phone.
You like negotiating and enjoy the rush of obtaining a contract.
You are a self-starter and do not need to be told what to do.
You admire the mission of SWC and take pride in doing your job well, in looking out for the interests of your company.
You like to work on unique problems, you just enjoy challenging yourself.
If this is you, then welcome aboard!
Responsibilities:
Contract Acquisition
Work in an inside / outbound / business-to-business sales capacity.
Approach new and existing payers from initial contact, and through follow-ups and escalations, with the goal of promoting SWC’s services.
Process, send and follow-up on emails, marketing collateral, applications, contracts and other documents required.
Schedule and attend telephone, Zoom and in-person meetings with payers nation-wide to pitch / present / discuss our unique clinical value proposition.
Travel will be necessary.
Maintain tenacious outreach, follow-ups, networking, and creatively search for leverage in turning a “no” into a “yes.”
Prioritize contracts for acquisition based on highest impact on accounts receivable.
Contract Negotiations
Understand economics of contract and SWC, and negotiate rate structures sustainable for both SWC and payers.
Ensure all contracts are appropriately identified, negotiated, implemented, audited, and renegotiated in a timely manner.
Negotiate agreements that support SWC goals and values and maximize service revenue.
Fulfill quality and reporting requirements by relaying clinical outcomes to payers as needed.
Maintain a shared repository of all executed contracts, exhibits, addendums, communications, etc.
Track renewals and re-credentialing with an efficient reminder system, collect documentation in advance and renew contracts in a timely manner.
Communicate payer contract changes with billing, credentialing and field clinical teams.
Analyze impact of new contracts and contract changes, report periodically.
Payer Relations
Build and maintain positive and effective working relationships with payers and work to improve communication and operational efficiency.
Resolve contract issues related to managed care contracts.
Initial monitoring to detect problems both on the SWC and payer side to resolve them early in the implementation process.
Travel to meet with payers as needed.
Qualifications & Experience
Bachelor’s or higher degree in public health, health administration, business administration, public policy or related field.
Payer contracting/relations 3+ years when working for a provider.
Demonstrated experience and results in reaching out to payers/insurance companies, communicating the value proposition of clinical services provided by your physician group, and obtaining contracts to provide those services.
Must be familiar with health care pricing and reimbursement methodologies.
Knowledge of network development processes, contract language, principles of negotiation and credentialing.
Ability to communicate effectively and work directly with clients, physicians, staff, managers, department heads, health plans and government agencies and community members.
Proficient in Excel.
Authorized to work in the United States without any restrictions.
Education
Bachelors or higher.
Job Benefits
Competitive salary + commission for contracts obtained.
Paid vacation days
Health insurance
Retirement plans
Professional development
Contact us Today!
Visit us at www.skilledwoundcare.com.
Skilled Wound Care will ask all candidates to perform pre-employment confidential DiSC testing and appropriate relevant skills testing prior to hiring.
Skilled Wound Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information.
“SWC” #ZR