Head of Payor

Company & Mission

We are on an ambitious mission to solve the healthcare shortage in the US by empowering independent practices to thrive. Our AI-powered software and services supercharge independent practices, helping them to grow their patient base and deliver better patient experiences.

About This Role

The Head of Payer will play a critical leadership role of establishing, managing and organizing relationships with payers, including private insurance companies, government programs and employers. Also,This role will be responsible for negotiating contracts, improving reimbursement rates, ensuring regulation compliance and a seamless billing process.

Location: in-person at our HQ in Redwood City, CA or remote (US)

Key Responsibilities

• Payer Relationship Management: Build and maintain strong relationships with insurance payers, acting as the primary point of contact.
• Strategy Development & Market Analysis: Develop and implement payer strategies aligned with the organization's goals. Conduct market analysis to identify trends, challenges, and opportunities in the payer landscape.
• Contract Negotiation: Lead contract negotiations with insurance payers to secure favorable terms and rates.
• Reimbursement Management: Work to improve reimbursement rates and streamline the billing process.
• Cross-Functional Collaboration: Collaborate with other departments, such as billing, coding, and compliance, to ensure cohesive payer strategies.
• Advocacy: Advocate for the organization's interests in discussions and negotiations with payers.

Required & Preferred Qualifications

• Experience: Minimum 7 years of experience in healthcare administration, with a specific focus on payer relations or contract management. Proven ability to negotiate and manage payer contracts and relationships.
• Industry Knowledge: In-depth understanding of the payer landscape, including trends and challenges.
• Leadership Experience: Experience in a leadership role, managing teams or major projects.
• Analytical Skills: Strong analytical skills, with the ability to conduct market analysis and develop strategic plans.
• (Preferred) Experience in Digital Health: Prior experience in the digital health sector is often preferred, as this provides a better understanding of the specific challenges and risks in this field.
• (Preferred) Knowledge of Regulatory Standards: A comprehensive understanding of laws, regulations, and standards affecting the digital health industry such as HIPAA, HITECH, GDPR, FDA regulations for digital health solutions, etc.

Compensation & Benefits

• Base salary range: $177,000 - $230,000
• Performance Bonus & Stock Option Plan
• Medical, dental, and vision coverage for employee and family
• Life Insurance and Disability Benefits
• 401(k) Retirement Plan with Company Match
• Generous Paid Time Off and Holidays
• Employee professional development and wellness program