VP of Payer Relations and Reimbursement
Odyssey Behavioral Healthcare - Brentwood
Work at Odyssey Behavioral Healthcare
Overview
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Overview
Why You Will Love Working With Us!
Odyssey Behavioral Healthcare believes that each person deserves the opportunity to embark on a new journey to reach their optimal level of health. Odyssey’s network of behavioral healthcare services provides support to individuals throughout their journey by combining compassionate, evidence-based treatment with concierge-quality amenities.
What we offer :
- Collaborative environment dedicated to clinical excellence
- Multiple Career Development Pathways
- Company Supported Continuing Education & Certification
- PPO & HDHP Health Plan Options
- Flexible Dental & Vision Plan Options
- 100% Company Paid EAP Emotional Well-Being Support
- 100% Company Paid Critical Illness (with health enrollment plan)
- 100% Company Paid Life & ADD
- 401K with Company Match
- Company-Sponsored HSA, FSA, & DSA Tax Savings Accounts
- Generous Team Member Referral Program
- Parental Leave
How You Will Contribute/Position Summary
The VP of Payer Relations and Reimbursement is a key member of Odyssey’s executive leadership team. S/he is chiefly responsible for cultivating and maintaining strategic partnerships with commercial payers, optimizing contracting and reimbursement processes, and maximizing growth initiatives via expansion of diverse payer contracts.
Essential Responsibilities
- Contributes to national strategic growth plans by evaluating, analyzing, and interpreting the payer landscape within a given market; establishes payer connections ahead of market entry.
- Provides executive team updates related to market trends, additional business opportunities, and obstacles within new and existing markets and service lines.
- Cultivates and maintains long-term relationships with commercial payers (and to a lesser extent, government payers) that align with Odyssey’s growth and service delivery goals.
- Leads negotiation, drafting, and execution of payer contracts, in collaboration with executive leaders, ensuring contract terms maximize reimbursement rates and service coverage while supporting Odyssey’s financial and clinical service objectives.
- Develops innovative pricing models and contract structures that maximize value and sustainability.
- Monitors contract performance regarding financial performance, payment integrity, and compliance with contract terms and key performance indicators.
- Ensures compliance with payer and government regulations, staying ahead of relevant policy changes that may impact reimbursement.
- Monitors payer activity with respect to network development, service line expansion and development, payment policies and other relevant market intelligence.
- Collaborates cross-functionally with internal teams to communicate Odyssey’s value proposition, effectively presenting Odyssey programs’ behavioral services, differentiation, and outcomes to maximize reimbursement.
- Oversees the credentialing process for the company and company providers.
- Communicates key contract requirement to ensure operational compliance and success.
What We Are Seeking/Education and Experience:
The position requires a minimum of a bachelor’s degree from an accredited college or university with a preference for master’s level education. Payer contracting experience within a behavioral healthcare delivery setting is preferred, although strong candidates with significant contracting experience in other medical specialties will be considered. The candidate should have a minimum of 10 years of experience in payer relations, reimbursement strategy, or revenue cycle management, with at least 5 years in a strategic senior leadership role. The successful candidate will have a proven track record of negotiating favorable contract terms, managing expectations, navigating regulatory environments and policy changes, and driving positive financial outcomes. S/he must possess a deep understanding of commercial and government payer priorities and the dynamics of healthcare reimbursement.
Odyssey Behavioral Healthcare provides equal employment opportunities without regard to race, color, creed, ancestry, national origin, ethnicity, sex, gender, sexual orientation, marital status, religion, age, disability, gender identity, genetic information, service in the military, or any other characteristic protected under applicable federal, state, or local law. Equal employment opportunity applies to all terms and conditions of employment. Odyssey Behavioral Healthcare reserves the rights to modify, interpret, or apply this job description in any way the organization desires. This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position. Reasonable accommodations may be made to reasonably accommodate qualified individuals with disabilities. This job description is not an employment contract, implied or otherwise. The employment relationship remains “At-Will.”