VP of Payer Account Management - Shearwater Health

VP of Payer Account Management

Type of Employment: Full Time
Department: CPO
Location: Nashville, TN
Travel: 15%-25% (based on client requirements)

Description:

The Vice President of Payer Account Management is responsible for developing, retaining and expanding our group health payer client base. Our ideal candidate will exemplify extraordinary rapport with Shearwater Health clients by identifying and understanding client needs, managing superior new client launches in concert with our Clinical Process Outsourcing (CPO®) leadership in the Philippines.

Responsibilities:

  • Performs regular customer contact, including weekly, bi-weekly, and/or monthly calls and routine business reviews with all clients to anticipate client needs, ensure satisfaction, identify potential or present performance issues, etc.
  • Learns and manages each client contract to ensure Shearwater Health is managing to the agreed upon terms and that client billing is on time and accurate.
  • Learns and documents work within the Salesforce application following the Shearwater Health procedures to communicate current status within the organization.
  • Be active owner with Finance and Operations in client budget forecasting process.
  • Navigates client environment with discretion, grace, and political and interpersonal sensitivity to ensure Shearwater Health and client goals are defined, documented and achieved in an environment where some client employees may resist change presented by Shearwater Health.
  • Maintains a balanced position when confronted with client concerns; demonstrates sensitivity towards customer issues, while ensuring that Shearwater Health’s policies, profitability and marketplace reputation are protected.
  • Serves as an expert listener and communicator with the designated client leadership and with Shearwater Health leadership about potential and developing client – Shearwater Health opportunities.
  • Ensures the delivery of excellent service by assisting with new client implementation, researching to resolve issues and problems; creating and delivering reports as needed for the client.
  • Collaborate with Operations and Clinical Leadership in the United States and in the Philippines to ensure client directives are clearly defined.

Required Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required.

  • Ability to anticipate, identify, and resolve problems in a timely manner; gather and analyze information skillfully; and generate reports, as needed.
  • Ability to demonstrate accuracy, thoroughness and have the acumen to monitor own work to ensure quality and apply feedback to improve performance.
  • Ability to adapt to changes in the work environment, manage competing demands, and manage frequent changes, delays and/or unexpected events.
  • Possess the ability to understand financial budgeting and performance indicators.
  • Articulate and professional presenter with an ability to convey a strategic growth plan
  • Ability to work independently and in team collaboration, including being adaptable to occasional need outside traditional work hours.
  • Detail oriented to process mapping and workflow planning.
  • Computer skills (Microsoft applications) with strength in Excel, PPT and Word as well as planning and CRM programs (Salesforce).
  • Excellent written and verbal communication skills, both remotely and in person.

Preferred Qualifications:

  • Bachelor’s Degree or higher with at least 5 years client facing payer experience
  • Demonstrated experience working with the clinical departments within a Health Plan strongly preferred
  • Knowledge and experience in Quality (HEDIS, Supplemental, and Risk Adjustment Coding) and/or Utilization Management within a Health Plan a plus

Employee Benefits:

• A competitive compensation structure
• Comprehensive health insurance
• 401(k)
• Paid holidays
• Paid vacation and sick time
• The opportunity to build your career in a rewarding and unforgettable way

About Shearwater

Because of a shortage of clinicians, it's difficult to scale healthcare organizations. Shearwater Health provides teams of remote and onsite clinicians that expand the size and impact of clinical teams, so that clients can focus on internal teams practicing at the peak of their license.

From bedside to back-office, there are over 3,000 Shearwater clinicians solving medical and administrative problems every hour of every day all over the world.

We couple our clinical expertise with Six Sigma business experts and Robotic Process Automation to improve outcomes and lower costs.

To be successful in our overarching solution to expand the size and impact of U.S. clinical teams both on-site in hospitals and off-shore in the Philippines, we cultivate a dedicated team passionate about finding the right talent and providing that talent with the right tools and training to provide quality work and care.