Area Vice President
Calix
CloudGoogle Cloud Platform
VP of Payor Contracting
SleepDoctor
full-time
Posted on:
Location Type: Remote
Location: Remote • Washington • 🇺🇸 United States
Visit company websiteSalary
💰 $195,000 - $230,000 per year
Job Level
Lead
About the role
- Create and lead a national, multi-year commercial payor contracting strategy for both our integrated PC (clinical) and DME (equipment) entities to achieve core business growth objectives
- Lead all negotiations to secure new and/or improved commercial contracts, ensuring optimal reimbursement rates and favorable utilization terms for both professional sleep services and Durable Medical Equipment
- Help develop financial models to evaluate contract performance, monitor KPIs, and ensure profitable network participation across all contracts
- Work directly with the RCM and Finance teams to ensure all negotiated contract terms are accurately loaded, interpreted, and operationalized for proper claims submission and payment
- Oversee all contracting activities to ensure strict adherence to federal and state healthcare regulations (e.g., Stark Law, Anti-Kickback Statute, HIPAA) and manage the timely credentialing process
- Serve as the primary liaison for all commercial payor relationships, providing strategic direction, and leading future contracting and team development efforts
Requirements
- Minimum of 10 years of progressive experience in healthcare payor contracting, with at least 5 years in a leadership/VP role.
- Proven track record of successfully negotiating commercial payor contracts for both a Professional Corporation (physician/clinical services) and a Durable Medical Equipment (DME) entity, ideally at a national level.
- Deep understanding of provider reimbursement methodologies (Fee-for-Service, Value-Based Care, CPT/HCPCS coding, DRGs, etc.) specific to both PC and DME services.
- Exceptional negotiation, communication (written and verbal), and presentation skills.
- Strong financial acumen and ability to analyze complex financial data, contract language, and reimbursement models.
Benefits
- Medical, vision, and dental insurance
- 100% of employee medical, vision, and dental premiums covered by the Company
- Option to participate in both a medical FSA and dependent care FSA
- 401(k) plan with fully matching contributions up to 3% of salary and 50% matching from 3% to 5%
- Paid Time Off in accordance with the Company’s policies
- Commuter benefits for Seattle-based employees
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
contract negotiationfinancial modelingKPI monitoringclaims submissionreimbursement methodologiesCPT codingHCPCS codingDRGsprovider reimbursement analysiscontract performance evaluation
Soft skills
leadershipcommunicationpresentationnegotiationstrategic directionteam developmentinterpersonal skillsorganizational skillsanalytical skillsproblem-solving
