Job Description

Job Description

The Virginia Hospital & Healthcare Association (VHHA) is seeking candidates for Senior Director, Payor Relations at our headquarters in Glen Allen, Virginia. Under the direction of the President & CEO, the Senior Director of Payor Relations works to advance the interests of Virginia’s hospitals and health systems with commercial payors (including Medicaid managed care and Medicare Advantage) through ensuring an effective working relationship with Virginia health insurers and developing and implementing strategies to promote patient and provider-friendly contracting and reimbursement policies. The Senior Director of Payor Relations will coordinate with other VHHA team members to advance the Association’s strategic priorities related to payors. He/she will serve as the lead staff member for the VHHA Payor Advisory Committee (PAC) and all related work groups and subcommittees.

Essential functions include:

·        Serves as the lead VHHA team member on all matters involving commercial health insurers (including Medicaid managed care and Medicare Advantage) in Virginia.

·        Advises VHHA’s leadership and VHHA members on payor policies, contracting, network adequacy, reimbursement, and other matters.

·        Coordinates and facilitates VHHA Payor Advisory Committee (PAC) meetings while maintaining compliance with antitrust requirements.

·        Coordinates and facilitates additional subcommittees and work groups of the PAC.

·        Writes and publishes a monthly newsletter for VHHA members on payor-related matters.

·        Fosters and maintains strong working relationships with representatives from Virginia health insurers and regulatory bodies with oversight over health insurers.

·        Works with the VHHA’s advocacy and policy team to develop legislative and regulatory proposals related to the insurance industry.

·        Represents VHHA and its members on regulatory committees and work groups applicable to health insurance and payor issues.

·        Reviews legislation and regulations related to the insurance industry, advises the advocacy and policy team during General Assembly sessions (and as otherwise appropriate and necessary), and assists with the development of collateral materials related thereto.

·        Performs the role of VHHA lead for all functions related to the payor scorecard initiative, including analyses for members and facilitating a scorecard user group.

·        Coordinates with VHHA’s Senior Vice President and General Counsel and others on matters before the State Corporation Commission’s Bureau of Insurance.

·        Monitors national trends in payor contracting, network adequacy, reimbursement, and other policies to anticipate potential future matters to address in Virginia.

·        Represents VHHA on multi-state state hospital association and national hospital association workgroups and at other meetings related to health insurers and payor policies.

·        From time to time, supervises outside contractors that are engaged to assist with payor-related matters.

·        Supports, organizes, and manages rapidly changing priorities and crisis situations in a focused and professional manner.

Ideal candidates will have extensive experience with commercial health insurance business, contractual, financial, operational, and other matters. Must have working knowledge of Medicaid managed care and Medicare Advantage. Strong written and verbal communication skills are required, as well as ability to solve and resolve problems in a timely manner. Must be able to work independently, set priorities and complete assigned tasks with minimal supervision.

This is a full-time position which requires travel within the Richmond metro area to attend meetings and occasional travel within Virginia and to Washington DC. Teleworking may be allowed based upon mutual agreement with supervisor. Occasional overtime and weekend hours are required. A bachelor’s degree and a minimum of 5 years of experience working with commercial health insurers, hospital/health system payor contracting/relations, or a regulatory body with oversight of commercial health insurers. Must have proficiency in Microsoft Office Suite.

Compensation will be commensurate with work experience. VHHA offers a competitive benefits package and incentive plan opportunity.

Interested candidates should send a cover letter and resume to recruiting@vhha.com.

VHHA is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, sex, national origin, age, disability, marital status, military service or veteran status, sexual orientation, gender identity, genetic information, pregnancy, childbirth, or related medical conditions, including lactation, political affiliation, or other basis prohibited by federal or state law relating to discrimination in employment.

It is the policy of VHHA to provide a drug-free workplace in keeping with the spirit and intent of the Drug Free Workplace Act of 1988. VHHA prohibits the manufacture, sale, distribution, dispensation, possession, or use of alcohol, controlled substances, or marijuana on VHHA premises or while conducting VHHA business on or off VHHA premises.

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