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Vice President of Managed Care

Company: KabaFusion
Location: Cerritos
Posted on: November 22, 2021

Job Description:

A career at KabaFusion means joining a team that empowers its team members to make a difference!

KabaFusion is a home infusion company with 19 pharmacies and the ability to service 40+ states. While we are known for our expertise in IVIg and SCIg, we also provide acute infusion and nutritional services.

Where KabaFusion truly excels, is in its approach to patient care and positive clinical outcomes. With our dedicated and highly skilled clinical staff and in-house nursing with 24 hour on-call service; we are well equipped to care for our patients.

What we offer:

* Competitive compensation
* Benefits start on your 1st day of employment
* 401K w/ 4% Match - no waiting or vesting period
* PTO / Floating Holidays / Paid Holidays
* Company Paid Life Insurance
* 3 Employee Assistance Programs (EAP)
* Emerging Leaders Training Program
* Perks--- includes discounts on travel, cell phone, clothing, and more---
* Employee Referral Program

JOB SUMMARY:

The Vice President of Managed Care is responsible for building and implementing the payor strategy for all states KabaFusion Holdings has a license to service patients. This individual will evaluate the current payor agreements and develop a comprehensive payor strategy which will include obtaining contracts from strategic payors in all markets nationwide. Furthermore, the position will also oversee authorization and billing issues, and then develop overall and payor-specific strategies to maximize revenue opportunities.

The Vice President will help build sales and marketing tools to support this strategy, and work in a "hands-on" manner to gain access to and close targeted payor contracts. Proactively negotiate contracts and manage all payor relationships while staying current with emerging trends and changes in policies that may affect the company's authorization, billing or reimbursement.

DUTIES & RESPONSIBILITIES:

* Must be able to develop the tools and supports to drive payor contracting
* Must be able to personally gain access to key payor decision makers, (i.e., network contracting executives, Medical Directors, Directors of Care Management, etc.) and to articulate KabaFusion's value proposition effectively.
* Secure contracts with commercial, managed Medicare, Medicare Part D and managed Medicaid payors at favorable rates.
* Supervise managed care Account Managers and a payor contracting specialist.
* Personally, deliver key sales presentations in collaboration with the CFO, CCO and CEO.
* Develop and execute strategies to improve access to decision makers within payor organizations that enable articulation of the value of its services and payor support program.
* Work collaboratively with Finance and Patient Financial Services staff to reduce the denial rate of claims submitted to payors.
* Work with the Sales leadership to develop "pull through" programs that leverage existing payor contracts.
* Support the sales team in signing & retaining physician customers due to payor reimbursement issues

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PREFERED EDUCATION & EXPERIENCE:

* Minimum of an undergraduate degree in a field relevant to sales and marketing is required. An advanced degree in business, marketing, public health, or a related field is also desirable, but not required.
* Minimum of 7 to 10 years of progressive leadership experience in managed markets contracting with a health services, or ancillary company.
* Experience working for a managed care organization is an asset but not required.

#managedcare #contracting #payor #healthcare #pharmacy #homeinfusion #infusion #managedmarkets #vicepresident #vp #director #leadership #medicare #medicaid #providercontracting

Keywords: KabaFusion, Cerritos , Vice President of Managed Care, Executive , Cerritos, California

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