Director of Healthcare Strategy
The Director of Healthcare Strategy has the responsibility of overseeing and leading the development and implementation of the health plan contracting strategy of the organization. They report directly to the CEO and are accountable for identifying potential partnerships, negotiating, implementing, and overseeing payor contracts and relationships. The Director will work closely with the financial analytics team to model all contract proposals, including fee-for-service and value-based arrangements (such as shared savings and bundles). They will also work closely with the contract operations team to troubleshoot contract operational issues and assist in resolving them by understanding the underlying contracts and leveraging payor relationships.
This position is a thought leader and strategic business partner to The Senior Alliance's CEO, helping formulate strategy and build strategic partnerships. The Director will share best practices, discuss learning curves, and analyze successes and failures. They will help the CEO stay attuned to customer needs and incorporate them into the marketing strategy. This position will prepare and present strategic presentations to The Senior Alliance Board of Directors and potential new customers.
The Director should be relatable and possess convincing authenticity that attracts others to listen to their advice and guidance. They will expand the leadership team's knowledge, encourage innovation, embrace and value collaboration, display empathy, and operate from a base of equality. By sharing their expertise and promoting The Senior Alliance brand, the Director will be recognized as a marketing expert and brand strategy champion for the entire Senior Alliance portfolio of services.
Primary Responsibilities
Business Development
- Cultivates and grows relationships within health plan organizations, including contracting, implementation, renewals, and milestone tracking, to ensure a consistent and valued client experience that can scale.
- Develops deep understanding of core client needs and opportunities, mapping The Senior Alliance capabilities against those needs to expand access to care for new populations.
- Expands access to care by managing relationships with health plan senior leadership across existing partners and identifies opportunities for growth.
- Carries out the strategic priorities and vision of The Senior Alliance with the senior leadership team.
- Leads the development of the payor partnerships strategy framework and content library, laying the groundwork for standard, scalable client relationships aligned with The Senior Alliance values.
- Stays ahead of market conditions, industry best practices, and client needs to inform strategic decision making and drive operational excellence.
- Meets with senior leadership to ascertain and develop strategic payor contracting goals.
- Prepares a business strategy for growth with goals, targeted customers, and timelines detailing key strategies and tactics.
- Researches, develops, and maintains up-to-date contacts at target companies and “keep in contact” system(s). Keeps the system updated with contact reports and utilizes calendar management to follow up with contacts as needed and when appropriate.
- Establishes, develops, and maintains a pipeline with solid prospects, meeting or surpassing the strategic goals.
- Meets with clients as needed in collaboration with The Senior Alliance CEO to conduct presentations.
Contract Negotiation and Execution
- Negotiates and closes contracts by coordinating with senior leadership and contract administrator and ensures financial and strategic goals are translated into contractual language accordingly.
- Ensures contract compliance and mitigates risks in collaboration with cross-functional teams to achieve program Key Performance Indicators (KPIs) such as client growth.
- Analyzes payor contract proposals with the financial analytics team to ensure contracts meet financial goals.
- Works closely with compliance and legal counsel to review and edit contracts as appropriate.
- Ensures internal stakeholders are aware of contract terms, reimbursement rates, and payor policies and that contract terms are appropriately communicated/translated into front- and back-end processes.
- Works closely with the revenue cycle teams to ensure contracts are loaded appropriately into billing and decision support systems.
- Works closely with the contract operations team, UM team, and revenue cycle teams to identify trends and opportunities in outstanding accounts receivable.
Strategic Relationship Management
- Escalates issues as necessary to payor contracts for resolution. In conjunction with contract management, recommends escalation through senior management as appropriate.
- Identifies trends/patterned issues to aid in contract renegotiations.
- Assesses contract administrative terms and advises leadership accordingly on measures of contract performance.
- Maintains up-to-date knowledge on the healthcare market, specifically regarding payor policies and reimbursement trends.
- Acts as the key contact with vital Senior Alliance joint venture partners by leading and attending meetings and serving as the representative of The Senior Alliance on all partnership matters.
Experience, Competencies, and Personal Characteristics
- Experienced (5+ years) in payor or provider, contract development, negotiation, implementation, and monitoring. Possesses a basic understanding of contract law and legal principles.
- Possesses excellent verbal and written communication skills and relationship-building skills, such as sales, marketing, fundraising, and community engagement.
- Possesses key payor contacts and knowledge of payor contracting. Proven track record of building and developing relationships within the healthcare industry.
- Knowledgeable of the healthcare industry and payor reimbursement methodologies (both hospital and physician).
- Experienced in developing and managing a Medicare Advantage plan, preferably an I-SNP or IE-SNP.
- Strategic thinker, with the ability to identify partnership opportunities that align with The Senior Alliance long-term goals and strategies.
- Ability to work independently and collaboratively to solve complex problems.
- Ability to influence and motivate others and works collaboratively within a multi-stakeholder environment.
- Professional when dealing with stakeholders. Uses good judgement and takes a thoughtful approach to resolving and communicating issues.
- Experienced in business development, strategic partnerships, or corporate relations; could include identifying, negotiating, and managing partnerships with external organizations.
- Possesses strong leadership skills and demonstrates capability to inspire staff to pursue excellence in goals and productivity. Capable of coaching and improving staff in need of professional development. Places high priority on overall team performance.
- Additional responsibilities as required to accomplish departmental and organizational goals.
Education
- Bachelor’s degree in health or business administration, economics or related subject is required with a minimum of 5 years’ experience in a senior leadership, business development role.
- Master’s Degree preferred, such as an MBA (Master of Business Administration), MHA (Master of Health Administration), MPH (Master of Public Health), or similar.
Working Environment
- Will be asked to perform this role in a hybrid office environment or other agency location.
- Must be able to travel approximately 50% of the time around Michigan.
- Must have access to reliable transportation that will enable travel to client or patient sites within a designated area.
- This position is based out of Wayne County, Michigan.
How to Apply
Email resume and cover letter with salary expections to awinton@thesenioralliance.org