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Director of Credentialing and Payor Contracting

Full Time

kindbody

About Kindbody

Kindbody’s mission is to make fertility and family-building care affordable and accessible for all. 

Founded in 2018, CB Insights recognized Kindbody as one of the world’s promising health companies. Kindbody was named to Inc.’s Best In Business list of most admired companies in 2021 and Fierce Healthcare named Kindbody to its Fierce 15 list of 2022, which recognizes the most promising healthcare companies in the industry. Kindbody is the trusted fertility benefits solution for more than 78 employers and thousands more receive their fertility care directly from Kindbody at our signature clinics. As the fertility benefits solution, the technology platform, and direct provider of high-quality care, Kindbody delivers a seamless, integrated experience with superior health outcomes at a lower cost for employers and consumers. Kindbody has raised $122 million in funding from leading investors including Perceptive Advisors, GV, RRE Capital and Claritas Health Ventures.

On February 1, 2022, Kindbody acquired Chicago-based Vios Fertility Institute which now provides Kindbody with a national footprint of over 26 locations with a dozen more planned in 2022.

To follow the latest Kindbody news, get to know our patients, and learn about what it’s like to work at Kindbody, you can follow us on Instagram, Linkedin, and Twitter.

About the Role

As an experienced Director of Credentialing and Payor Contracting reporting to our VP, Growth Operations, you will be working in a fast-paced, rapidly growing environment where you will be relied on for your expertise, professionalism, and collaboration. This role is a remote FULL-TIME position.

Responsibilities

  • Build Credentialing and Payer Contracting capability within the overall operations team, including selection and training of team members, creating SOPs and operational key performance indicators
  • Assist in the creation and provide support in the execution of a comprehensive payer credentialing program
  • Identify appropriate contracting needs, interpret payer-specific requirements, and interact with health plan counterparts, providers, and other applicable Kindbody team members to promote alignment
  • Strive to limit the usage of non-participating agreements, by evaluating the utilization of non-pars and the financial ability to ensure revenue is obtained 
  • Support other functional areas (People, Clinical, Revenue Cycle, EMR teams, etc.) with reports and data relating to all contracts and staff payer credentialing
  • Supervise and direct deliverables of the team, ensuring all Kindbody providers are properly licensed, credentialed and have all necessary hospital privileges
  • Develop and monitor contract negotiation schedules, timelines, contractual deadlines, and annual pricing renewals
  • Work with Operational and Legal leaders to facilitate the full contract negotiation/re-negotiation cycle from assessment and identification of contract opportunities through implementation of the contract; negotiating and managing complex and innovative payer contracts striving to maximize revenue and maintain competitive reimbursement rates
  • Develop and maintain relationships with the payers as the primary contracting lead serving as a resource for operational leaders and manage payer interactions from a contracting, value-based care, operations, and provider relations standpoint
  • Lead, support and facilitate governance of payer contracting activities and oversee that third party payer contracts are signed by all parties necessary to ensure appropriate plan enrollment 
  • Monitor system interfaces for data timeliness and accuracy. Report missing and inaccurate data or apparent inconsistencies in data to appropriate departments when discovered for correction.
  • Review, redline, and negotiate FFS contract language for payers alongside Kindbody’s legal counsel
  • Communicate with clients directly as required

Who You Are

  • Bachelor’s Degree or equivalent required 
  • Managed care contracting experience required 
  • Contracting experience with all payor mix types
  • Adept to regulatory, private, federal, and state guidelines
  • Knowledge and understanding of multi-tax ID business model
  • Ability to negotiate key terms and reimbursement 
  • Proficient in identifying, summarizing, and calculating payment/reimbursement policies
  • Effective project management skills

Perks and Benefits

Kindbody values our employees and wants to do everything to ensure that our employees are happy and professionally fulfilled, but also that they have the opportunity to be healthy.  We are committed to providing a number of affordable and valuable health and wellness benefits to our employees, such as paid vacation and sick time; paid time off to vote; medical, dental and vision insurance; FSA + HSA options; Company-paid life insurance; Short Term + Long Term Disability options; Paid Parental Leave (up to 12 weeks fully paid dependent on years of service); 401k plans; free Peloton membership, monthly guided meditation and two free cycles of IVF/IUI or egg freezing and free egg storage for as long as you are employed.

Additional benefits, such as paid holidays, commuter transit benefits, job training & development opportunities, social events and wellness programming are also available.  We are constantly reevaluating our benefits to ensure they meet the needs of our employees.

In an effort to protect our employees and our patients, Kindbody is requiring all employees to be fully vaccinated against Covid-19.  Any candidate seeking employment at Kindbody will be required to be fully vaccinated against COVID-19 and provide proof of your COVID-19 vaccine prior to your start date of employment. If you cannot receive the COVID-19 vaccine because of a qualifying legal reason, you may request an exception to this requirement from the Company.

 

Kindbody is an Equal Employment Opportunity employer. We strongly support the principles of equal employment opportunity in all of our employment and hiring policies and practices and believe that a more diverse and inclusive workplace will benefit our patients, care partners, and Kindbody employees. We administer our employment and hiring policies and practices without regard to race, color, religion, sex, gender, gender identity, gender expression, pregnancy, citizenship, national origin, ancestry, age, disability, medical condition, military service, military or veteran status, genetic information, creed, marital status, sexual orientation, or any other status protected by federal, state, or local law.

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