Demant is a leading international hearing healthcare company that develops, produces, and sells hearing solutions, accessories, diagnostic instruments, and personal communication. The group operates in a global market with companies in more than 30 countries, employees exceeding 14,000, and revenues of well over 2 billion USD. Demant has a strong presence in the US market and is looking for outstanding passionate talent committed to the goals and mission of the company.

This high visibility, leadership role who is responsible for the organization’s overarching managed care strategy and payer relationships relative to developing the benefit design and pricing strategies for the hearing benefit manager.    Leading the managed care analytic and negotiating in partnership with the President and in conjunction with the VP of Provider Relations & Contracting role, this position is the primary architect building and shaping managed benefit and pricing designs, as well as aligning the goals of operational leaders within key payer partners.

To perform this job, an individual must perform each essential function satisfactorily with or without reasonable accommodation. 

• Collaborate with senior leadership to develop future and execute current MC strategies for all benefit designs and pricing strategies
• Work closely with creating tiered platforms of pricing, capitations models, value-based care and revenue cycle leadership to maximize total reimbursement yield and keep #1NewCo’s assets ‘network essential’ to payers
• Integrate and align payer strategy with #1NewCo growth and strategic objectives, including Fee for Service, capitation, PMPM, and value-based contracting strategies, taking into account various pricing and benefit initiatives, consumerism, digital health, service line development investments, operational process
• Research and monitor insurance industry activities, healthcare reform, and payer strategy to inform managed care, capitation, pricing and benefit design relative to hearing health, value-based care and other product, organizational priorities
• Participate in committees to gain knowledge and influence in state and federal issues
• Lead the managed care team in annual budgeting and planning work, working with underwriting, finance, and executive leaders
• Assume leadership role in complex, high-impact negotiations with key payers to ensure financial viability and optimized contractual terms
• Oversee the development and implementation of monthly financial dashboards for key performance insight relative to pricing and benefit design activities
• Create clear insight in the form of quarterly reports to summarize managed care negotiating activities at the market level
• Lead the development of tools shedding light on the performance of key contracts
• Work closely with finance, and underwriting colleagues and health plan contacts to address chronic, trended issues impeding optimal contract yield respective to hearing life
• Ensure managed care team is closely aligned with operations to develop and implement relevant managed care initiatives supporting areas of growth and opportunity
• Create a sustainable managed care pricing and benefit design structure to ensure (a) proper training of new hires, (b) resources for experienced team members and (c) a pipeline of talent for succession planning
• Regular and reliable attendance.
• Perform other duties as assigned.

Education: Bachelor’s degree, preferred advanced degree, MBA, Finance, Business Management, Underwriting, Actuarial Services.

Experience: Minimum of 7 years of managed care pricing modeling, benefit design, along with negotiation and contracting activities experience

Skills and Abilities:

• Financial analysis
• Contract modeling
• Alternative payment methodologies
• Key terms and conditions contract language
• Negotiation strategy/tactics including escalated payer negotiation disputes
• Relevant regulatory and compliance issues
• Highly proficient working knowledge of Microsoft operating systems i.e., Word, Excel
• Must possess excellent written and oral communication skills
• Must be self-motivated and able to meet deadlines
• Optimistic, solution-oriented, collaborative by nature
• Knows how to cultivate, support and sustain a high-performing team
• Possess good organizational skills with high executive function acumen

The Company is an Equal Opportunity / Affirmative Action employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.