Healthcare Payor and Pricing Director at Craneware


Title: Healthcare Payor and Pricing Director

  • Location: United States
  • Office Location: Home-based, Full-time Remote position

Role Overview:

Reporting to the Senior Vice President of Revenue Intelligence, this role develops and leads the Payor and Reimbursement team in implementing the plan, processes and related payor reimbursement and pricing policies that result in high quality, best practice services to our customers all over the US.

Craneware is a market leader in providing extremely powerful value cycle solutions to our customers, and we are recognized as one of the Becker’s Healthcare Revenue cycle Management companies to know.

Key Accountabilities:

  • Provide leadership and monitoring of Revenue Intelligence SOW for Trisus Pricing Analyzer solution to assure the delivery of quality services and implementation training that meet or exceed customer expectations.
  • Develop efficient best practice methods for delivery of services based on current market needs and/or impending market trends and/or efficiency of the delivery of services to assure maximum profitability.
  • Work directly with Product Management and Engineering teams to provide voice of the customer input into product enhancements based on customer needs.
  • Support sales efforts in developing existing and new customer relationship. Supports new business development through extended networking and at the attendance of conferences and industry events and performing demos of the product.
  • Ensure team is compliant with respect to all legal and regulatory requirements, ethics and integrity, managing risk effectively.
  • Management of consulting, knowledge, best practice and techniques within the existing team
  • HR functions such as recruitment, contribution management, motivation and team building. This includes the identification and implementation of professional development required for direct reports and team development interventions to ensure a high performing team.
  • Represent the organization externally to lead project teams addressing customer issues and influencing external key stakeholders towards actions and decisions in favor of Craneware.
  • Participate in internal cross-functional team meetings in US and UK.

Knowledge and Experience:

  • Educated to a Bachelor’s degree preferably in Healthcare Administration, Business, or Finance.
  • Extensive knowledge of payer contracting and payment systems.
  • Exceptional leadership and communication skills with the ability to deliver across own function and cross-functional teams.
  • Excellent communicator and influencer; understand the importance of frequent and effective communication
  • Coaching and mentoring skills
  • Microsoft Office – ability at intermediate level
  • Strong verbal and written communication skills, including presentation facilitation.

Required Experience:

  • 7+ years’ experience of operating in a leadership role in the US Healthcare Industry
  • 3+ years’ experience analyzing payor reimbursement for incorrect payments and adjudicating claims
  • Deep and broad knowledge of customer’s operational best practices; payor reimbursement, healthcare pricing strategies and Craneware products
  • Experience working in both payor and/or hospital environments preferred
  • Previous consulting experience preferred
  • Healthcare payment methodology operations experience
  • Experience managing, developing and mentoring a team

Other Details:

  • Self-confident; willing to raise concerns through appropriate channels
  • Highly accountable and results oriented

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