Why Mayo ClinicMayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans (https://jobs.mayoclinic.org/benefits/) – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. You’ll thrive in an environment that supports innovation, is committed to ending racism and supporting diversity, equity and inclusion, and provides the resources you need to succeed.ResponsibilitiesThe Senior Director, Contracting and Payer Relations provides:
Leadership for the development and oversight of strategies for contacting with third-party payers for all Mayo Collaborative Services, initially to include reference lab and CV monitoring services.
Successfully secures payer contracts at acceptable reimbursement with highest possible level of in-network benefits and coverage.
Works in partnership with relevant MCS departments and clinical experts to develop and deploy data-driven reasoning to effectively convince payers to cover and include MCL differentiated testing as in-network.
Develops trust and builds relationships with health plan medical directors and policy makers to communicate and potentially collaborate to validate the clinical and economic value of all MCS services provided, and/or vetted and backed, by Mayo Clinic expertise.
Responsible for all negotiations, management and maintenance of payer contracting activities for all MCS services and site(s), to include all third-party payers, and their programs.
Oversees relationships with many types of entities including insurance companies, managed care plans, employers/corporations, business coalitions, high value payer programs, and governmental entities. The MCS Senior Director and/or its direct reports negotiate financial terms and administrative policies of all contracts directly with payers’ senior level management.
Responsible for financial performance of third-party payer contract portfolio for all MCS services and as assigned other functions/programs/future service lines. Responsible for collaborating with Mayo Clinic CPR and Finance leaders as applicable to ensure MCS contracting strategies and activities are separate yet compatible with Mayo Clinic practice/site CPR contracting, strategic initiatives, and financial models.
Serves as institutional resource and educates Mayo leadership regarding managed care reference laboratory contracts, payer markets, and competitive trends.
Serves as a primary MCS/CPR contact and collaborator for site Administrators, Physician CEOs/Leaders, and CFOs.
Qualifications
Ten (10) years’ experience in health care finance or administration with demonstrated leadership skills is required, with at least five (5) years directly involved in reference lab contract negotiations and revenue cycle management in a provider or payer organization.
Bachelors’ degree, preferably in a business-related field is required.
An MBA, MHA or other relevant Master’s degree will be highly preferred. Scope of experience, a proven track record of success and demonstrated career progression may be considered in lieu of degrees.
Broad knowledge regarding healthcare financing and extensive knowledge regarding reference laboratory revenue cycle billing/claims/coding, and coverage policies are necessary.
Required skills include:
Strategic thought leadership with ability to lead contracting teams;
Excellent communications and human relations skills, including negotiating skills, to interact effectively with high level contacts within and outside of the organization;
Excellent analytical and problem-solving skills to strategically assess contract performance and impact of trends and developments in health care on Mayo Collaborative Services’ third-party contracted revenue.
Exemption StatusExemptCompensation DetailEducation, experience and tenure may be considered when job offers are extended. Compensation range is $181,542.40 -$272,292.80/Year.Benefits EligibleYesScheduleFull TimeHours/Pay Period80Schedule DetailsMonday - Friday, regular business hours.Weekend ScheduleNot applicable, only required if business needs arise.International AssignmentNoSite DescriptionJust as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. (https://jobs.mayoclinic.org/alllocations)Affirmative Action and Equal Opportunity EmployerAs an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.RecruiterCristal BlancoEqual opportunityAs an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.
Full-time