About the Role:

The Senior Vice President, Payor Relations is responsible for developing and executing Palmetto Infusion's payer strategy across all lines of business, including commercial, Medicare Advantage, Medicaid managed care, and government payors. This leader will build and maintain high-value relationships with payor partners, drive contract optimization, and align payer strategy with the company's overall growth objectives.

The SVP, Payor Relations serves as the primary external-facing executive for all payer and reimbursement matters, and will work closely with Finance, Operations, Revenue Cycle, and Business Development to support enterprise performance.

The SVP, Payor Relations may participate or lead in the following:

• Annual Operating Plan including payor-specific market growth initiatives
• Evaluation of potential acquisition targets and payor network implications
• Quarterly Board presentations on payer strategy and contract performance
• Strategic planning sessions with executive leadership and the CFO

Minimum Qualifications:

• A minimum of 12-15 years of progressive experience in managed care, payer relations, or healthcare contracting, with a proven track record; experience in specialty pharmacy, infusion, home health, or related healthcare services preferred.
• Demonstrated success negotiating complex, multi-payer managed care contracts including value-based/population care; deep knowledge of commercial insurance, Medicare Advantage, and Medicaid managed care structures, benefit design, and reimbursement methodologies.
• Knowledge of episodic healthcare procedures and reimbursement policies (e.g., Part B & D drug reimbursement, ASP/AWP, PBM structures) strongly preferred.
• Ability to sell a service and build executive-level relationships with health plans and health system leadership; experience with new business development required.
• Self-starter and strategic thinker; must be able to assume a flexible work schedule and manage multiple priorities with competing deadlines.
• Must have excellent interpersonal skills in handling interactions with clinic staff, other agencies, executive leadership, payers, and patients and families.
• Strong financial acumen with experience in contract modeling, rate analysis, and P&L management; ability to apply percentages, ratios, and financial concepts to practical situations.
• Competent in use of company email, CRM or contract management platforms, electronic medical records, and the company website and reporting tools.
• Knowledge of and sensitivity to cultural and language differences; must be able to work as a team member and develop productive, cooperative working relationships with all members of the health care team.
• A record of satisfactory performance in all prior and current employment as evidenced by positive employment references.
• A college degree, preferably in Business, Healthcare Administration, Finance, or equivalent work-related experience. Master's degree (MBA, MHA) strongly preferred.

Essential Functions:

Strategic Payer Leadership

• Develop and lead a comprehensive payer relations strategy aligned with Palmetto Infusion's mission, growth targets, and service line expansion.
• Serve as a senior spokesperson and executive partner with health plans, PBMs, GPOs, and government agencies.
• Evaluate market trends in reimbursement, value-based care, and specialty infusion benefit design to inform enterprise strategy.
• Support the Vision, Mission, and Core Values of Palmetto Infusion in all payer-facing interactions.

Relationship Management

• Build and maintain executive-level relationships with medical directors, network management officers, and senior leaders at key payer organizations.
• Facilitate joint operating committees, quarterly business reviews, and strategic planning sessions with top payer partners.
• Manage team-selling efforts at the branch and corporate levels; maintain strong working relationships across all departments.

Market Management & Prospecting

• Identify and target new payer partners/markets for evaluation by corporate personnel and key account members.
• Assess and report competitive payer activities; assist in developing and implementing competitive strategies.
• Acts as a change agent to foster favorable core therapy growth month over month and year over year in both acute and chronic service lines.
• Complete all expenses, mileage, and time sheets within budget, submitted to CFO in a timely fashion.

Government & Regulatory Affairs

• Monitor federal and state legislative and regulatory developments affecting infusion reimbursement and managed care.
• Engage with CMS, state Medicaid agencies, and relevant trade associations to advocate favorable coverage and payment policies.
• Promote compliance with applicable payer contract requirements, prior authorization mandates, and utilization management protocols.

Communication & Reporting

• Provide regular feedback to CFO and executive leadership regarding payer activity, contract status, and market development.
• Develop and submit weekly/monthly payer relations KPIs; work with executive leadership monthly to evaluate and measure company performance.
• Participate in bi-weekly executive leadership meetings and Performance Improvement Programs.
• Demonstrate skills and ability in effective professional written and verbal communications.

About the Benefits:

• Competitive Compensation
• Comprehensive Medical Insurance
• Dental and Vision Insurance
• Company Life Insurance
• Voluntary Life and Disability Insurance
• Additional Voluntary Supplemental Plans
• Flexible Spending Account (Medical and Dependent Care)
• Health Savings Account
• 401K Retirement Plan
• Employee Assistance Program (EAP)
• Employee Discounts
• Ramsey SmartDollar Program
• Referral Program
• Tuition Assistance
• Paid Time Off
• 8 Paid Company Holidays

Physical Demands:

• The physical demands described here are representative of those that must be met by an employee to successfully perform the primary functions of this job. While performing the duties of this job, the employee may be required to frequently stand, walk, sit, bend, twist, talk, and hear. There may be prolonged periods of sitting, keyboarding, reading, as well as driving or riding in transport vehicles. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include reading, distance, computer, and color vision. Talking and hearing are essential to communicate with patients, vendors, and staff.

Patient Advocacy Statement:

At Palmetto Infusion, we believe that patient advocacy is at the heart of everything we do, regardless of our roles within the organization. Each member of our team is dedicated to putting the needs and well-being of our patients first. Whether we're working directly with patients or supporting them behind the scenes, our commitment to being a compassionate advocate is paramount. We understand that every interaction, every decision, and every effort contribute to the quality of care our patients receive.

Together, we strive to ensure that every individual feels heard, supported, and empowered throughout their healthcare journey. This dedication to patient-centered care is what creates "The Palmetto Experience" - a standard of excellence that defines us and enriches the lives of those we serve.

OTHER

All employees must uphold the confidentiality of protected health information and follow all HIPAA policies. This position has access to sensitive information and a breach of information may be grounds for immediate termination.