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Position:

Value Based Care Contracting Vice President

Position Summary:

Responsible for overseeing the successful development and execution of payer contract negotiations. Directs all payer contracting for multiple client partnerships including, development activities, contracting standards, payer negotiations, and value-based programs pertinent to payer contracting. Establishes and implements long-term goals and high-quality contracting strategy for the department.

Job Description:

Primary Responsibilities

• Oversees and ensures success of the function. Helps develop, support, and promote personal growth across the team. Accountable for the operations of the function, including workload distribution, goal setting, performance management, and development.
• develops, promotes growth, and ensures personal and team success for the function. Participates in team member recruiting, succession planning, career development plans, team member goal setting/review, DE&I initiatives, and other People & Culture related activities as needed.
• Provides, develops, implements, and continually evaluates the strategic direction for the vision of the future state of the department(s). Develops strategic initiatives and techniques to ensure the company remains at the forefront of modern practice.
• Guides and participate in high-stakes negotiations with payers to ensure favorable contract terms that align with Lumeris strategies.
• Establishes and maintains strong relationships with payer representatives, serving as key point of contact for contract-related discussions and issue resolution.
• Evaluates proposed contracts and assess financial viability, operational feasibility, and alignment with Lumeris strategies.
• Develops and implements performance tracking mechanisms to monitor contract effectiveness and impact of payer contracts providing regular updates to SVP.
• Supports the implementation of Lumeris ARO payer relations and contracting strategies that align with overall business goals.
• Collaborates with internal and external partners to gather insights, align contract terms, and address contract related issues.
• Provides expert knowledge of managed care and value-based care innovations to inform contract negotiations.
• Creates meaningful impact on continuous improvement and scalability across all aspects of the organization. Oversees the creation, implementation, and evaluation of quality metrics, KPIs, data integrity standards, process improvement and strategic initiatives, and knowledge sharing.
  

Qualifications

• Bachelor's Degree in Health Care Administration or Business or related field or equivalent
• 15+ years of experience in managed care network development and provider relations/contracting management or the knowledge, skills, and abilities to succeed in the role
• Significant people, program, or project leadership experience at an executive level
• Expert knowledge Value Based Care Contracting, budget creation/management, resource allocation, and contract/vendor management
• Exemplary business acumen, executive presence, and a demonstrated ability to create and enhance strategic relationship
• Topnotch communication, collaboration, presentation, and negotiation skills
• Distinguished ability to impact results in a high-performing and high-growth environment
• High-caliber analytical skills with the proven ability to identify, develop, communicate, implement, and guide process improvements and strategic initiatives
  

Working Conditions

• While performing the duties of this job, the employee works in normal office working conditions.

Disclaimer

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals wth disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.

The hiring range for this position is:

$175,300.00-$249,100.00

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. This role may also be eligible for incentive compensation. At Lumeris, we are committed to providing a total rewards package that supports your overall well-being. Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more. Learn more by visiting our Careers Page.

Member Facing Position:

No- Not Member or Patient Facing Position

Location:

Remote, USA

Time Type:

Full time

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.