Job Title:Director, Payer Development
Reports To:President- Revenue Cycle Management
Location:Hybrid Schedule
Business Unit Description:National Accounts
Job Title/High-Level Position Summary: The Director of Payor Development (DPD) is responsible for establishing, maintaining and improving Payor access for Enovis products while driving the business of our largest Payor accounts in a medium- to large-size region to achieve budgeted sales and manage profitable growth. This position is responsible for understanding each account and building the business through fact-based knowledge by positioning our products, programs, and promotions to help maximize sales. The goal of the DPD is to help drive the overall relationship(s) forward and drive product penetration and Payor revenue in national customer engagements.
Key Responsibilities:- Responsible for managing business development, account development, customer satisfaction, client relationships, and overall account strategies.
- Accountable for achieving budgeted sales of assigned accounts.
- Partners with Account Executives and functional team leaders to expand business within an assigned territory.
- Capitalizes on industry knowledge, product knowledge and coverage, and contacts to uncover business opportunities.
- Articulates sales and solutions in terms of ROI to the customer.
- Develops a vision and account strategy for long-term profitable growth, consistent with the long-range plans of the business.
- Assesses competitive price position ensuring Enovis products are competitively priced to maximize sales and profitability within account and account competitors and consistent with brand positioning.
- Identifies, evaluates, plans, and champions ongoing cost reduction initiatives.
- Profiles key Payors to assess applicable coverage policies, utilization controls, coverage review practices and timelines, geographic coverage areas, level of regional or national influence, and other attributes relevant to optimal patient access for Enovis products.
- Identifies opportunities to expand Enovis' penetration into existing accounts for additional services and ways for Enovis to add value to the customer.
- Leads the development and negotiation of Payor contracts across assigned account, as applicable.
- Liaises with Marketing to provide strategic insight on pricing and contracting initiative.
- Participates and leads cross-functional teams to accomplish sales and profit objectives.
- Effectively supports all other applicable functional teams on specific Payor customers' coverage policies and coverage status.
- Identifies competitive threats and develops response strategies to ensure optimal Payor access for products.
- Creates customer proposals that include project scope, approach, and pricing.
- Collaborates with Service Leaders and other P&L Leaders to ensure proposal content is effective and complete.
- Monitors ongoing projects within the customers organization.
- Participates in major quality review of Enovis projects.
Relationship Building- Manages Executive Level (C-Suite) relationships and negotiates high-risk solutions.
- Develops ongoing relationships with targeted accounts/territory with customer executives to ensure Enovis is considered as a strategic business advisor to the customer's organization.
- Establishes himself/herself as a trusted business advisor to the customer's organization.
- Works with new and existing accounts to establish and maintain customer relationships and secure volume.
- Ensures client satisfaction and addresses concerns and/or issues promptly.
- Coordinates and communicates with leaders and Senior Management on a regular basis.
Compliance- Compliantly engages Medical Affairs resources to support optimal product access across assigned region/accounts.
- Maintains knowledge of third-party payor regulations including Medicare, Medicare Advantage, Medicaid, Workers Compensation, and non-governmental payers to ensure Enovis conducts its Revenue Cycle Management activities in compliance with applicable rules, policies, and guidance.
- Demonstrates commitment to the Compliance & Ethics Program, the Enovis Code of Conduct, the Enovis Sales and Marketing Code of Conduct, the AdvaMed Code of Ethics, and all supporting and applicable regulations, policies, and procedures.
- Adheres to all internal Corporate Compliance guidelines, OIG, government healthcare regulations, regulatory policies and procedures, and privacy and security standards in accordance with government agencies, including HIPAA requirements.
- Treats Protected Health Information (PHI) with the strictest confidentiality in accordance with HIPAA standards.
- Acquires a basic understanding of the field to include regulatory compliance issues and adheres to these guidelines.
- Other duties as assigned.
Minimum Basic Qualifications:- Minimum of 15 years of experience working in a healthcare-related field required.
- Experience negotiating pricing and contracts directly with Payors required.
- History of achieving sales quotas and expanding customer relationships required.
- Experience presenting to and calling on executive level (C-Suite) call points required.
- Demonstrated success in working with Payors required.
- Experience leading sales pursuit and/or customer engagement teams in a matrix environment.
- Knowledgeable of healthcare provider budgets, operations, and industry drivers.
- Understanding of computer system capabilities and provider software solutions to address process requirements.
Travel Requirements:- Must be able to travel up to 75% of the time.
- Typical work-related travel assignments range 1-5 days, and as such overnight, out-of-town stays are required.
- Position requires car and air travel on a routine basis.
Desired Characteristics:- Negotiation/Influence
- Risk Taking/Judgment
- Technical Skills
- Quality Management
- Analytical Skills
- Business Acumen
- Initiative
- Industry Knowledge
- Financial Management
- Strategic Thinking
Currently, Enovis does not provide sponsorship for employment visas (e.g., H-1B) and will not offer such sponsorship in the future. Applicants must already have full-time work authorization in the United States, both now and in the future, without requiring sponsorship.We offer a comprehensive benefits package that includes:
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Spending and Savings Accounts
- 401(k) Plan
- Vacation, Sick Leave, and Holidays
- Income Protection Plans
- Discounted Insurance Rates
- Legal Services
#LI-RC2
