[Hiring] VP of Payor Contracting @Sleep Doctor

Remote, USA Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role DescriptionThe VP of Payor Contracting is responsible for developing and executing a comprehensive national commercial payor contracting strategy across both the Sleep Doctor PC and DME entities. • Lead all aspects of contract acquisition, negotiation, and maintenance with commercial insurance companies (HMOs, PPOs, Managed Care Organizations). • Ensure favorable reimbursement rates, optimal contract terms, and broad network access for integrated services.• Possess deep expertise in both physician/facility contracting and DME contracting. • Proven track record of securing profitable agreements with major national and regional payors. What You Get To Do Every Day• Create and lead a national, multi-year commercial payor contracting strategy for both integrated PC (clinical) and DME (equipment) entities to achieve core business growth objectives. • Lead all negotiations to secure new and/or improved commercial contracts, ensuring optimal reimbursement rates and favorable utilization terms for both professional sleep services and Durable Medical Equipment.• Help develop financial models to evaluate contract performance, monitor KPIs, and ensure profitable network participation across all contracts. • Work directly with the RCM and Finance teams to ensure all negotiated contract terms are accurately loaded, interpreted, and operationalized for proper claims submission and payment. • Oversee all contracting activities to ensure strict adherence to federal and state healthcare regulations (e.g., Stark Law, Anti-Kickback Statute, HIPAA) and manage the timely credentialing process.• Serve as the primary liaison for all commercial payor relationships, providing strategic direction, and leading future contracting and team development efforts. Qualifications• Minimum of 10 years of progressive experience in healthcare payor contracting, with at least 5 years in a leadership/VP role. • Proven track record of successfully negotiating commercial payor contracts for both aProfessional Corporation (physician/clinical services) and a Durable Medical Equipment (DME) entity, ideally at a national level.• Deep understanding of provider reimbursement methodologies (Fee-for-Service, Value-Based Care, CPT/HCPCS coding, DRGs, etc.) specific to both PC and DME services. • Exceptional negotiation, communication (written and verbal), and presentation skills. • Strong financial acumen and ability to analyze complex financial data, contract language, and reimbursement models. Benefits• Compensation Range: $195,000 - $230,000/yr, with final compensation subject to the candidate’s specific qualifications and location.• Eligible to participate in the company’s annual bonus plan with a bolthires bonus opportunity of 15% of the base salary. • Medical, vision, and dental insurance with 100% of the employee premiums covered by the Company. • Option to participate in both a medical FSA and dependent care FSA. • 401(k) plan with fully matching contributions up to 3% of salary and 50% matching from 3% to 5% of salary. • Paid Time Off in accordance with the company’s policies. • Commuter benefits for Seattle-based employees. Company DescriptionSleep Doctor is committed to bringing together individuals from diverse backgrounds and perspectives.We strive to create an inclusive environment where everyone can thrive and be their authentic self, feel a sense of community, and do great work together. We are proud to be an equal opportunity employer open to all qualified applicants. Apply tot his job
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