Healthcare Payer Relations & ACO Manager

Position Title: Healthcare Payer Relations & ACO Manager

Lead Value-Based Care Strategies with EPIC Health

At EPIC Health, we're redefining healthcare with innovative solutions that improve outcomes for patients and communities. As our Healthcare Payer Relations & ACO Manager, you'll be at the forefront of optimizing value-based reimbursement strategies, fostering payer partnerships, and driving Accountable Care Organization (ACO) initiatives. If you're ready to lead transformative efforts in healthcare administration, this is your opportunity to make a real difference.

What You'll Do

Value-Based Reimbursement

• Develop and execute strategies to maximize value-based reimbursement opportunities.
• Analyze financial and operational data to identify trends and areas for improvement.
• Collaborate with clinical and financial teams to ensure alignment with value-based care goals.

Payer Relations and Contract Negotiations

• Establish and nurture strong relationships with insurance payers and healthcare partners.
• Negotiate payer contracts to ensure favorable terms while meeting regulatory requirements.
• Serve as the primary point of contact for resolving payer-related issues.
• Strategize and lead payer contract negotiations to optimize financial performance and reimbursement.

Accountable Care Organization (ACO) Management

• Oversee ACO programs, including performance monitoring, reporting, and compliance.
• Develop and implement strategies to enhance quality of care, patient satisfaction, and financial outcomes.
• Collaborate with clinical and administrative teams to effectively execute ACO initiatives.

Regulatory Compliance

• Ensure compliance with federal, state, and local regulations related to value-based reimbursement and ACO operations.
• Stay informed of changes in healthcare regulations and payer requirements.
• Develop policies and procedures to maintain regulatory compliance.

Data Analysis and Reporting

• Perform detailed analyses of reimbursement trends and financial performance.
• Prepare and present actionable reports to senior management, highlighting key insights and recommendations.
• Leverage data to drive decision-making and strategic planning.

What You Bring

Education

• Bachelor's degree in healthcare administration, business administration, finance, health law, or a related field required.
• Master's degree preferred.

Experience

• At least 5 years of experience in healthcare administration, payer relations, value-based reimbursement, or ACO management.
• Proven success in negotiating contracts and managing relationships with insurance payers.
• Expertise in data analysis and financial reporting in a healthcare setting.
• Experience collaborating across departments within a matrix organization.

Skills and Competencies

• In-depth understanding of value-based reimbursement models and ACO operations.
• Exceptional negotiation and communication skills.
• Proficiency in data analysis, financial modeling, and reporting tools.
• Strong problem-solving and critical-thinking abilities.
• Ability to manage multiple priorities in a fast-paced environment.
• Comprehensive knowledge of healthcare regulations and compliance standards.

Why Join EPIC Health?

What We Offer

• Competitive Salary: Your expertise and contributions are valued.
• Comprehensive Benefits: Health, dental, vision, and more.
• Professional Development: Opportunities to advance your skills and career.
• Collaborative Culture: Join a mission-driven team committed to innovation and patient-centered care.

Ready to Lead the Future of Value-Based Healthcare?

If you're a results-oriented professional passionate about improving healthcare delivery, we want to hear from you.

Apply today and join EPIC Health in shaping the future of patient care.

Visit www.epichs.org to learn more about us.