Senior Payer Operations Manager
2024-11-17
USA
Hs
About the Senior Manager Payer Operations (Relations) at Headspace:
The Senior Manager Payer Operations brings a deep experience in both payer contracting and operations. The individual will be responsible for supporting Headspace payer partnerships and the negotiation, execution and compliance with the network agreements Headspace has with all payers.
What you will do:
Further develop the payer relations function within Headspace, including collaboration across departments and teams and alignment with financial and compliance goals
Develop strategy to gain more payer agreements (and client specific networks) nationally and regionally in collaboration with partnerships, DTC, and employer direct teams, supporting strategic payer partners
Negotiate in-network contracts on behalf of Headspace, including fee for service
Drive end-to-end network contracting process, including plan for recontracting and renegotiation over contract lifecycle, and ongoing account/relationship management
Bring market knowledge and expertise, combined with data insights, to drive negotiation and contract strategy
Support Headspace's Revenue Cycle Management team in working with payer to resolve claims submission and payment issues and processes
Partner with compliance and legal teams to assure compliance with payer specific requirements
Negotiate delegated credentialing agreements with payers
Interface with any Credentialing Verification Organizations on behalf of Headspace.
Responsibility for overseeing payer claims/notes audit
What you will bring:
Required Skills:
6+ years of contracting and network experience
Experience contracting with or on behalf of a payer (including provider relations)
Understanding of health plan network operations, billing, collections and payer network management
Strong negotiation skills with a track record of results
Effective relationship builder and collaborator, internally and externally
Proven ability to drive end-to-end network contracting process
Analytical and data-driven skills
Preferred Skills:
Digital health experience
Pay & Benefits:
The base salary range for this role is determined by a number of factors, including but not limited to skills and scope required, relevant licensure and certifications, and unique relevant experience and job-related skills. The base salary range for this role is $113,000 - $159,000.
At Headspace, cash salary is but one component of our Total Rewards package. We’re proud of our robust package inclusive of: base salary, stock awards, comprehensive healthcare coverage, monthly wellness stipend, retirement savings match, lifetime Headspace membership, unlimited, free mental health coaching, generous parental leave, and much more. Paid performance incentives are also included for those in eligible roles. Additional details about our Total Rewards package will be provided during the recruitment process.
How we feel about Diversity, Equity, Inclusion and Belonging:
Headspace is committed to bringing together humans from different backgrounds and perspectives, providing employees with a safe and welcoming work environment free of discrimination and harassment. We strive to create a diverse & inclusive environment where everyone can thrive, feel a sense of belonging, and do impactful work together.
As an equal opportunity employer, we prohibit any unlawful discrimination against a job applicant on the basis of their race, color, religion, gender, gender identity, gender expression, sexual orientation, national origin, family or parental status, disability*, age, veteran status, or any other status protected by the laws or regulations in the locations where we operate. We respect the laws enforced by the EEOC and are dedicated to going above and beyond in fostering diversity across our workplace.
*Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on Headspace. Please inform our Talent Acquisition team by filling out this form if you need any assistance completing any forms or to otherwise participate in the application or interview process.
Headspace participates in the E-Verify Program.
Privacy Statement
All member records are protected according to our Privacy Policy. Further, while employees of Headspace (formerly Ginger) cannot access Headspace products/services, they will be offered benefits according to the company's benefit plan. To ensure we are adhering to best practice and ethical guidelines in the field of mental health, we take care to avoid dual relationships. A dual relationship occurs when a mental health care provider has a second, significantly different relationship with their client in addition to the traditional client-therapist relationship—including, for example, a managerial relationship.
As such, Headspace requests that individuals who have received coaching or clinical services at Headspace wait until their care with Headspace is complete before applying for a position. If someone with a Headspace account is hired for a position, please note their account will be deactivated and they will not be able to use Headspace services for the duration of their employment.
Further, if Headspace cannot find a role that fails to resolve an ethical issue associated with a dual relationship, Headspace may need to take steps to ensure ethical obligations are being adhered to, including a delayed start date or a potential leave of absence. Such steps would be taken to protect both the former member, as well as any relevant individuals from their care team, from impairment, risk of exploitation, or harm.
For how how we will use the personal information you provide as part of the application process, please see: https://www.headspace.com/applicant-notice
The Senior Manager Payer Operations brings a deep experience in both payer contracting and operations. The individual will be responsible for supporting Headspace payer partnerships and the negotiation, execution and compliance with the network agreements Headspace has with all payers.
What you will do:
Further develop the payer relations function within Headspace, including collaboration across departments and teams and alignment with financial and compliance goals
Develop strategy to gain more payer agreements (and client specific networks) nationally and regionally in collaboration with partnerships, DTC, and employer direct teams, supporting strategic payer partners
Negotiate in-network contracts on behalf of Headspace, including fee for service
Drive end-to-end network contracting process, including plan for recontracting and renegotiation over contract lifecycle, and ongoing account/relationship management
Bring market knowledge and expertise, combined with data insights, to drive negotiation and contract strategy
Support Headspace's Revenue Cycle Management team in working with payer to resolve claims submission and payment issues and processes
Partner with compliance and legal teams to assure compliance with payer specific requirements
Negotiate delegated credentialing agreements with payers
Interface with any Credentialing Verification Organizations on behalf of Headspace.
Responsibility for overseeing payer claims/notes audit
What you will bring:
Required Skills:
6+ years of contracting and network experience
Experience contracting with or on behalf of a payer (including provider relations)
Understanding of health plan network operations, billing, collections and payer network management
Strong negotiation skills with a track record of results
Effective relationship builder and collaborator, internally and externally
Proven ability to drive end-to-end network contracting process
Analytical and data-driven skills
Preferred Skills:
Digital health experience
Pay & Benefits:
The base salary range for this role is determined by a number of factors, including but not limited to skills and scope required, relevant licensure and certifications, and unique relevant experience and job-related skills. The base salary range for this role is $113,000 - $159,000.
At Headspace, cash salary is but one component of our Total Rewards package. We’re proud of our robust package inclusive of: base salary, stock awards, comprehensive healthcare coverage, monthly wellness stipend, retirement savings match, lifetime Headspace membership, unlimited, free mental health coaching, generous parental leave, and much more. Paid performance incentives are also included for those in eligible roles. Additional details about our Total Rewards package will be provided during the recruitment process.
How we feel about Diversity, Equity, Inclusion and Belonging:
Headspace is committed to bringing together humans from different backgrounds and perspectives, providing employees with a safe and welcoming work environment free of discrimination and harassment. We strive to create a diverse & inclusive environment where everyone can thrive, feel a sense of belonging, and do impactful work together.
As an equal opportunity employer, we prohibit any unlawful discrimination against a job applicant on the basis of their race, color, religion, gender, gender identity, gender expression, sexual orientation, national origin, family or parental status, disability*, age, veteran status, or any other status protected by the laws or regulations in the locations where we operate. We respect the laws enforced by the EEOC and are dedicated to going above and beyond in fostering diversity across our workplace.
*Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on Headspace. Please inform our Talent Acquisition team by filling out this form if you need any assistance completing any forms or to otherwise participate in the application or interview process.
Headspace participates in the E-Verify Program.
Privacy Statement
All member records are protected according to our Privacy Policy. Further, while employees of Headspace (formerly Ginger) cannot access Headspace products/services, they will be offered benefits according to the company's benefit plan. To ensure we are adhering to best practice and ethical guidelines in the field of mental health, we take care to avoid dual relationships. A dual relationship occurs when a mental health care provider has a second, significantly different relationship with their client in addition to the traditional client-therapist relationship—including, for example, a managerial relationship.
As such, Headspace requests that individuals who have received coaching or clinical services at Headspace wait until their care with Headspace is complete before applying for a position. If someone with a Headspace account is hired for a position, please note their account will be deactivated and they will not be able to use Headspace services for the duration of their employment.
Further, if Headspace cannot find a role that fails to resolve an ethical issue associated with a dual relationship, Headspace may need to take steps to ensure ethical obligations are being adhered to, including a delayed start date or a potential leave of absence. Such steps would be taken to protect both the former member, as well as any relevant individuals from their care team, from impairment, risk of exploitation, or harm.
For how how we will use the personal information you provide as part of the application process, please see: https://www.headspace.com/applicant-notice