FoundFO

Director of Payer Strategy & Contracting

We wanted something that stopped focusing on short term weight loss and started emphasizing long term weight care.

Found

Employee count: 51-200

Apply now

Found is an evidence-based weight care platform that combines the best of modern medicine with lasting behavior change, access to personalized coaching, and a supportive community. Centered around clinical excellence, Found provides its members with a doctor-designed, comprehensive, and personalized weight loss program that delivers long-term, sustainable results.

Found’s members are supported by a team that includes providers to prescribe effective medication that addresses the root cause of someone’s weight challenges, combined with the best of consumer technology to provide behavioral health interventions delivered through our app for guidance on nutrition, movement, sleep, and emotional health.

Found is one of the largest medically-assisted weight loss programs in the country, having served 200,000+ Americans to-date and funded by leading investors like Atomic, Google Ventures, WestCap, IVP, TCG, Define Ventures and more. For more information, visit www.joinfound.com, follow on Instagram @joinfound and Facebook @joinfoundhealth.

About the role
The Director of Payer Strategy & Contracting will lead the strategic development and execution & negotiation of telehealth service contracts with payers. This role is responsible for creating and implementing innovative contracting strategies to enhance the Found’s market position and financial performance. The Director will oversee provider enrollment and credentialing functions, manage credentialing vendor(s) and internal team, and work in concert to support the Revenue Cycle Management (RCM) functions. The Director will collaborate with internal stakeholders, including finance, clinical operations, and legal & compliance teams, to ensure the alignment of payer contracts with organizational goals.

What you'll do (Job Responsibilities)

Strategic Planning:

  • Review, refine, and implement a comprehensive strategy for Found’s initial and ongoing payer contracting approach
  • Identify market opportunities and emerging trends in telehealth to inform strategic planning
  • Collaborate with executive leadership to align the contracting strategy with overall organizational objectives and goals

Revenue Cycle Management (RCM) Support:

  • Collaborate with the RCM team to ensure telehealth contracts support optimal revenue cycle performance.
  • Provide guidance on billing and reimbursement issues related to telehealth services.
  • Address and resolve payer-related issues impacting RCM functions.

Provider Enrollment and Credentialing:

  • Lead and manage provider enrollment and credentialing functions to ensure timely and accurate provider onboarding.
  • Develop and implement processes to streamline and improve provider credentialing.
  • Ensure compliance with all credentialing and enrollment regulations and standards.
  • Oversee credentialing vendors and ensure their performance meets organizational standards.

Market Analysis:

  • Conduct market research and analysis to identify competitive trends and opportunities.
  • Assess the financial impact of contracts and propose strategies to maximize revenue and reimbursement
  • Monitor and analyze changes in telehealth reimbursement policies and regulations

Contract Negotiation:

  • Establish and maintain strong relationships with payer representatives to facilitate successful negotiations
  • Lead the negotiation of contracts with applicable commercial payers as defined by the over arching payer strategy
  • Ensure contracts are financially favorable and compliant with regulatory requirements

Stakeholder Collaboration:

  • Work closely with internal teams, including finance, operations, legal, and clinical departments, to support fee for service initiatives.
  • Provide guidance and support to operational teams to ensure the successful implementation of payer contracts
  • Communicate effectively with senior leadership and other key stakeholders to report on contracting activities and outcomes

Performance Management:

  • Establish metrics and KPIs to evaluate the performance of payer contracts
  • Monitor contract performance and identify areas for improvement
  • Prepare and present regular reports on telehealth contract performance to senior leadership

Education: Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or a related field required. Master’s degree desirable.

Experience: Minimum of 7-10 years of experience in healthcare payer contracting, with a minimum 2-3 year focus on telehealth services.

  • Proven track record of successful contract negotiation with commercial and government payers.
  • Experience in strategic planning and market analysis.
  • Experience managing provider enrollment and credentialing functions.
  • Knowledge of Revenue Cycle Management processes and best practices.

Skills:

  • Strong understanding of telehealth services and reimbursement models.
  • Excellent negotiation and communication skills.
  • Ability to analyze complex data and make strategic decisions.
  • Strong leadership and project management skills.
  • Knowledge of healthcare regulations and compliance.
  • Proficiency in credentialing and enrollment software and systems.

Found is an Equal Opportunity Employer. We seek and celebrate diversity in its many forms. If you’re excited about this opportunity but do not meet 100% of the qualifications, we encourage you to apply.

Please review our CCPA policies.

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About the job

Apply before

Jul 21, 2024

Posted on

May 22, 2024

Job type

Full Time

Experience level

Executive

Location requirements

Open to candidates from all countries.

Hiring timezones

Worldwide

About Found

Learn more about Found and their company culture.

View company profile

We wanted something that stopped focusing on short term weight loss and started emphasizing long term weight care. Something backed by science, not just by celebrities.

At Found, we are dedicated to improving people’s overall wellbeing by making evidence based weight loss accessible & affordable for all.

Because it’s not just about what you lose, it’s about what you find.

We believe that

  • everyone should have access to proven methods of weight care.

  • weight loss is more complex than eat less, move more.

  • biology, psychology, and social contributors all influence weight care.

You’re in good hands

99% of US doctors are not trained in managing obesity and overweight. We have access to compassionate, board-certified medical experts that are specially trained in obesity.

Our values

Our modern weight care platform provides a personalized, innovative, integrated, accessible, and lasting solution. This approach is grounded in our values:

🏔 NO TWO PATHS ARE THE SAME

💖 STRONG HEART, OPEN MIND

👐 BUILD A BIGGER TABLE

💪 CONSISTENCY OVER INTENSITY

🔗 WIN TOGETHER

Employee benefits

Learn about the employee benefits and perks provided at Found.

View benefits

Retirement Savings

Found helps secure your future with a 401(k) retirement savings plan.

Paid Company Holidays

Found observes company-paid holidays, giving team members time to rest and celebrate.

Flexible PTO

Employees at Found enjoy flexible paid time off, allowing for a healthy work-life balance.

WiFi Perks

Found provides WiFi perks to support employees' home internet costs, ensuring seamless connectivity.

View Found's employee benefits
Claim this profileFound logoFO

Found

Company size

51-200

Founded in

2019

Chief executive officer

Sarah Jones Simmer

Employees live in

View company profileVisit joinfound.com

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