About this role
GEMCORE’s continued success has earned us national recognition with Inc. Magazine’s list of America’s Fastest-Growing Companies and with the Cleveland Plain Dealer as Top Workplace 6 years running! We are looking for qualified candidates who share our enthusiasm and drive for winning and want to be part of our caring culture!
Are you looking for a role that is part of a key initiative that is vital for the growth of the organization? All the while allowing for work/life balance? Edwards Health Care Services, Inc., a division of GEMCORE is a well-established and growing healthcare distribution company specializing in highly efficient distribution through its nationwide wholesale, retail, and pharmacy divisions. We are seeking a highly motivated Sr. Manager Payer Partnerships to join our high energy, friendly team. The Sr. Manager Payer Partnerships’ main responsibility is to manage the Edwards Health Care Services, Inc. Key Payer Network Program consistent with company growth objectives.
We offer growth opportunities with potential for advancement
This position is an in-office position located in Hudson, OH
Schedule is 8:15 am - 5:00 pm, Monday through Friday
Employer paid vacation
Benefits available included medical/dental/vision, life, short and long-term disability insurances, and 401K Retirement Savings Plan
Ongoing training and development
Key duties and responsibilities:
Identify and remain current on payer trends and be knowledgeable of the industry leaders in the commercial, Medicare, Medicaid, networks and self-funded, payer markets.
Procure payer contracts from designated sources, expand relationships with preferred payers and secure new opportunities
Assess the profitability of payer contracts in accordance with division goals and validate the terms of payer contracts through review and negotiation.
Identify payor marketing channels and recommend strategies to maximize utilization of payer contracts.
Nurture payer relationships and promote EHCS service and capabilities with key points of contact.
Communicate pertinent payer contract changes to company personnel on a timely basis.
Produce manufacturer payer reports
Key Requirements:
Knowledge of HCPC coding.
Familiarity with durable medical equipment fee schedules.
Exposure to benefits interpretation.
Advanced research and problem- solving capacity.
Ability to multi-task, adapt to change and prioritize work assignments.
Proficient with all Microsoft Office applications Word, Excel, PowerPoint etc. with high internet acumen.
Good organizational and cognitive reasoning ability.
Strong written and verbal communication skills.
5-7 years of experience in provider relations or network management.
College degree, preferred.
Light lifting of up to 25 pounds.
Travel as required.
Other facts
About Edwards Health Care Services, Inc.
A GEMCORE family company, Edwards Health Care Services, Inc. (EHCS) is your first-choice provider of direct-to-home, high quality medical products and diabetes supplies. For more than 25 years, we have been lighting the way to better health by offering our customers an easier way to have products delivered directly to their door. By partnering with healthcare professionals, product manufacturers, and a large network of government and private insurers, we are able to fulfill our deep commitment of personalized customer service and simplified order process for every customer...every time!
What you'll do
- The Sr. Manager Payer Partnerships is responsible for managing the Key Payer Network Program to align with company growth objectives. This includes procuring payer contracts, assessing profitability, and nurturing payer relationships.
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