VP, Payor Strategy & Relations

PURPOSE AND SCOPE:

The Vice President of Payor Strategy & Relations is responsible for developing payor strategy and driving successful partnerships with commercial and government payors for Fresenius Kidney Care. This leader ensures that payor strategies and reimbursement models align with organizational goals and industry best practices to optimize revenue and margin. Responsibilities span strategic planning, analytics innovation, operational execution, and team leadership, directly impacting organizational growth and financial sustainability.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Develop and implement comprehensive payor strategies that align with Fresenius Medical Care's business goals across both fee-for-service and value-based care models.
• Establish and maintain strong relationships with key payor organizations to explore partnership opportunities, enhance collaboration, and implement innovative strategies to improve revenue and margin.
• Evaluate new/enhanced payor revenue opportunities through alternative revenue streams.
• Continually monitor and evaluate federal and state healthcare regulations and Medicare reimbursement policies and methodologies with potential impact on private payor contracts, reimbursement models, and relationships.
• Represent the organization in industry forums and payer/provider advisory boards to influence reimbursement policy and proactively evaluate and prepare for industry and market shifts impacting payor reimbursement.
• In partnership with Managed Care and Revenue Strategy & Integrity leadership, develop key payor negotiation strategies to secure and enforce favorable payor contract terms, including reimbursement rates and contractual provisions, to maximize revenue growth.
• Collaborate with Insurance Coordination and Revenue Cycle leadership to influence favorable payor mix through patient advocacy and admissions strategies.
• Oversee the analysis of payor contract performance, payor reimbursement trends, payor forecast models, and financial outcomes to identify opportunities for revenue and margin improvement and inform strategic decisions.
• Build and lead a team of Payor Strategy & Relations professionals in fostering a collaborative environment to achieve departmental and organizational objectives.
• Work closely with internal departments, including Managed Care, Revenue Strategy & Integrity, Insurance Coordination,
• Operations, Revenue Cycle, and Finance to ensure alignment and effective execution of payor-related initiatives.
• Perform additional responsibilities as assigned to support the company's overall success.

PHYSICAL DEMANDS AND WORKING CONDITIONS: