Greater Purpose and Core Values:
Athletico’s Greater Purpose is to empower people, inspire hope and transform lives. We accomplish this by providing exceptional, progressive, and cost-effective fitness, performance and rehabilitative services through personalized care that emphasizes education and prevention of future injury. This is accomplished through building on our Core Values of one team, understanding our business, recognition, people-focused, accountability, continuous innovation and trust and integrity, which are the foundation for our unique culture.

Position Summary:

The Manager of Payor Relations partners with the Senior Vice President Payor Relations on the development and implementation of payor strategy, focusing on payor operations, client services, and process improvement. This role ensures resolution of payor issues received from Operations or other internal departments, implementation and communication of payor or plan changes, tracking of opportunities, and continual documentation and improvement of processes.

Essential Duties and Responsibilities:

• Drive the development and implementation of payor strategy in partnership with the Senior Vice President and Director of Payor Relations.
• Assist with credentialing and demographic updates of professionals in payor directories to ensure timely payment for services provided.
• Collaborates with Operations, legal, billing, and compliance to track and resolve payor issues, including payment and/or billing disputes.
• Continually create, document, and improve processes to provide clear communication throughout the lifecycle of contracting and pricing.
• Determine and implement any tools or technology required to assist in providing communication and updates to leadership and other relevant stakeholders.
• Manages contract repository and any documentation relevant to the negotiation, strategy, and/or implementation of the contract.
• Proactively monitor and report current contracting efforts.
• Partner with leadership to ensure that contracting efforts align with company and divisional goals.
• Communicate with relevant stakeholders to ensure contract commitments are operationalized.

Qualifications

• Education:
  • Bachelor’s degree
• Work Experience:
  • 5+ years healthcare experience, preferably with a payor or provider.
  • Prior health care provider or health plan contracting, contract operations, service operations, or provider relations experience preferred.
  • Minimum 2 years’ management level experience.
• Certification/Licensure:
  • None required
• Knowledge and Technical Skills:
  • Ability to manage competing priorities in a fast-paced environment and exercise independent judgement on matters of significance.
  • Understanding of government reimbursement.
  • Proficient working knowledge of different provider reimbursement methodologies required (fee schedules, per diems, per visit rates, etc.).
  • Comprehensive knowledge of Microsoft Office applications.
  • Outstanding communication, presentation, negotiation and relationship-building skills; able to engage with all levels within an organization.

Language Skills

• Ability to read, write and speak English proficiently.

Physical Demands: 

• Ability to fulfill office activities including but not limited to remain stationary for extended periods of time (i.e., while working at a desk), stoop/kneel/crouch, travel around the office, communicate with others (verbal and written), and use fine motor skills including fine hand manipulation and keyboarding.
• Ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus
• Occasionally lift and/or move up to 20-25 pounds 

Work Environment: 

• Consistent with a standard office environment, noise level is low with little to no extraordinary environmental factors.

Athletico provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.