This is an exciting time to join our dynamic organization. OPKO Health is a diversified healthcare company that seeks to establish industry-leading positions in large, rapidly growing markets, including pharmaceuticals, diagnostics, and biologics. OPKO's diagnostics business includes BioReference Laboratories, the nation's third-largest and fastest growing clinical laboratory over the last 35 years, which provides diagnostic testing to physician offices, hospitals, and clinics, among others, and GeneDx, a rapidly growing genetics and genomics laboratory that applies cutting edge technologies to make efficient clinical diagnostic testing and interpretation available for individuals with rare and common genetic conditions. Come join our team and become part of something big, by making our patients and customers the highest priority.
Reporting to the VP of Payer Relations, the Payer Relations Analyst is responsible for building and managing the large volume of payer related data generated by BioReference and its subsidiaries in compliance with all regulatory requirements, helping to provide business intelligence tools to aid in strategic business development opportunities and manage risks related to third party payers, all in accordance with the core values of BioReference Laboratories.
Duties may include but are not necessarily limited to the following:
Drive the overall strategy of the company with health plans and payers to achieve short-term and long-term goals. This includes customer targeting, understanding key customer needs and aligning the company value proposition appropriately.
Develop and manage third party payer data to drive enhanced business intelligence and improve reimbursement while maintaining regulatory compliance.
Build and maintain third party payer billing data warehouse to provide holistic reporting tools across all lines of business and subsidiaries.
Support the development of tools for efficient day to day management for client and/or segment nationally and/or across multiple regions.
Develops and manages processes to ensure expected service delivery for specific client and/or segment across the enterprise.
Develops key organizational links to people and functions and removes barriers to problem resolution.
Collaborate with management and staff to ensure alignment on priority service issues effecting the region(s).
Manage third party payer contract performance metrics and benchmarking tools.
Provide education and training to staff regarding decision support tools in accordance with strict reporting guidelines and discipline.
Work effectively with individuals across multiple departments throughout the organization.
Embrace, embody and represent the BioReference Laboratories company culture at all times to external and internal constituents.
B.S. in Business Administration, Information Technology, or Finance required (MBA or MS in IT a plus).
Advanced knowledge of SQL.
3+ years of experience in the independent clinical laboratory industry.
Ability to engage in a consultative selling process that overcomes objections and indifferences while connecting client needs with the company's capabilities.
Comfortable interfacing at the executive level (CEO, COO, CLO, CFO, EVP, SVP).
Keen understanding of managed care and health plan operations including reimbursement in the clinical laboratory space.
Ability to work independently, communicate proactively, manage multiple projects and prioritize daily tasks while managing critical deadlines.
Outstanding project management and planning skills.
Superior listening and problem solving skills.
Ability to handle sensitive information and maintain a very high level of confidentiality.
Possess a very positive attitude and an understanding of the dynamics involved with organizational growth and change.
Must be very proficient with all Microsoft Office products with advanced MS Excel and MS Access skills required (SQL Server a plus).
BioReference Laboratories is an Equal Opportunity Employer