Overall Objective

Responsible for negotiating and securing all Payor contracts, private and public, for Pentec Health in the assigned geography.  This position is accountable for establishing and maintaining positive long-term relationships with key personnel in targeted payors in order to secure and maintain in-network status for Pentec Health.

Duties and Responsibilities

The following tasks are considered to be typical and significant, any one or all of which may be performed by this position:

1.       Under minimal supervision, the Regional Account Manager (RAM) leads all Pentec Health initiatives with targeted regional managed markets accounts, which include Regional Independents, Blue Plans, Medicare Part D and Medicaid.

2.       Conceiving, creating and managing the negotiation, analyzing profitability, positioning the agreement internally, coordinating the selling effort, creating the marketing plan, insuring effective and efficient pull-through, forecasting and measuring its results, and conducting ongoing business reviews.

3.       Work with the New Market Development Team to develop account targets for securing participating provider contracts in each new market.

4.       Meet directly with key payor personnel to establish a relationship between them and Pentec Health and to differentiate us versus competition.

5.       Work closely with Field Sales Team to secure participating provider contracts for key plans affecting targeted referral sources in new and existing geographies.

6.       Thoroughly understand the clinical services and specific market segment messages as it relates to Specialty Infusion.

7.       Assist Reimbursement team with outstanding claims issues.

8.       Monitor internal reports as they relate to managed care performance, identify and develop strategies for measureable improvement for payors in assigned geographic markets.

9.       Responsible for communicating and ensuring implementation of applicable updates to payors’ policies/procedures and administrative processes.

10.    Perform other duties as assigned by the Director.