Company Description

MGA Homecare has been providing Private Duty Nursing, Skilled Nursing Visits, Occupational Therapy, Physical Therapy, and Speech Therapy services within the home and community-based setting for over a decade. In 2022 MGA has opened its doors to MGA Behavior Therapy which offers Applied Behavior Analysis (ABA) and early behavior intervention for pediatric patients with autism spectrum disorder (ASD) and other developmental disabilities.
 
We aim to help our patients and their families by delivering high-quality clinical care in the comfort of their homes. Our goal is to make the lives of our patients and their families easier by demonstrating compassion and integrity at the heart of everything we do. By bringing individualized attention and support throughout every home. MGA Homecare is proudly serving the states of Arizona, Colorado, North Carolina, Tennessee, Texas, and Washington, and are here to be a resource for patients and their families.

If you are seeking a rewarding career opportunity with a growing healthcare company that values its employees and patients, then apply now to join the MGA family!

Job Description

As the Director of Payer Relations at MGA Homecare, the incumbent holds a pivotal role in driving the organization's efforts to secure and manage contracts for provider funding and relationships with all payers. Reporting directly to the VP of Government Affairs and Payer Relations, this position is characterized by a high degree of collaboration and requires a profound partnership with various departments within MGA Homecare. The primary focus is on aligning payer (i.e. managed care, commercial, and local education agencies) with the organization's current and future programs, enhancing visibility, and advocating for MGA with external payer partners.

Roles and Responsibilities:

• Develop and execute a comprehensive strategy for funding in alignment with organizational priorities, collaborating closely with leadership to advance MGA Homecare’s position as the home and community-based provider of choice.
• Analyze all existing contracted rates by payer in each market and develop a prioritized timeline and workflow of which rates need renegotiation to meet organizational goals.
• Keep abreast of funding trends (e.g. performance/value-based agreements, single care agreements, alternative payment models) and develop and maintain relationships with government agencies, commercial payers, and managed care organizations.
• Evaluate opportunities for new contracting strategies with performance-based or value-based contracting. Evaluate payers in markets where MGA performs services. Determine strategic payer partners and align with the payer to increase patient volume and revenue for MGA.
• Understand how MGA service lines are funded (i.e., state plan, waiver services, fee for service, Medicaid, Managed care, private pay, etc.) state by state.
• Ensures maximum third-party reimbursement by conducting contract negotiations and pricing to drive profitable revenue growth with managed care organizations, commercial payers, and schools (i.e. local education agencies, districts, etc.).
• Maintain a high level of expertise in pricing arrangements, contract requirements/contract language, value-based initiatives and quality measures with the various health plans, etc.
• Attend relevant events to build connections with key groups and stay updated on health care payer industry trends and opportunities.
• Manage process for timely renewals of contracts in collaboration with compliance and credentialing to ensure payer contracting is maintained to ensure profitability.
• Adhere to all laws, statutes and regulations regarding anti-kickback and anti-trust.

Qualifications

• Bachelor’s degree required, Master’s degree preferred.
• Demonstrated knowledge and experience with health care payer landscape.
• Ability to analyze payer trends and policy developments impacting healthcare reimbursement with the ability to develop sound recommendations.
• Possess excellent written and oral communication skills, interpersonal skills, and ability to work both individually and as part of a team in a fast paced, professional environment.
• Fits the MGA culture (disciplined, adaptable, supportive, creative)
• Willingness to travel for job duties.
• Ability to Pass Background Check

Additional Information

Benefits include:

• Competitive wages
• Medical, Dental & Vision Coverage – Available 1st of the month following 30 days of employment
• Health Savings Accounts (HSA)
• Flexible Spending Accounts (FSA)
• Voluntary Short Term & Long Term Disability
• Employee Assistance Program (EAP)
• 401(k) retirement plan
• Paid Time Off (PTO)
• 7 Company Paid Holidays
• 100% Company Paid Life Insurance
• Voluntary Life Insurance
• Accident, Hospital, and Critical Illness Insurance
• Identity Theft Protection Plan
• Discounted Legal Care Plan

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