Job Description

Element Science, Inc. is a medical device and digital health company focused on developing solutions at the intersection of clinical-grade wearables, machine learning algorithms, and lifesaving therapies in order to address leading causes of death and hospitalization in patients with heart disease, primarily as they transition from the hospital-to-home. By putting the needs of patients and physicians first, our personalized digital devices, which are designed for function, comfort, and ease-of-use, aim to redefine the paradigm of care for these patients.  Our first product, a wearable patch defibrillator, is initially targeted at treating the more than 500,000 patients in the US with an elevated temporary risk of potentially experiencing a lethal heart rhythm.  Based in San Francisco, our funders include Third Rock Ventures, Google Ventures, Deerfield Healthcare, Qiming Venture Partners USA, Cormorant Asset Management, and Invus Opportunities.

SUMMARY OF ROLE:

The Senior Director of Payor Relations has enterprise level responsibility for providing strategic and operational leadership in the development and execution of all types of payor contracting programs. This role serves as the face of the Company to all payors and their partners. The role will have substantial impact on revenue and growth across all commercialized products. The Senior Director is expected to exercise independent judgment in the day-to-day management of the organization's contracting and billing activities. 

We welcome candidates that are based in the Midwest and Southeast of the United States, if not currently located in the San Francisco Bay Area.

RESPONSIBILITIES:

• Develop and execute strategies to establish and enhance relationships with payors, including insurance companies, government agencies, and other third-party payors.
• Oversee payor contracting to ensure favorable terms and conditions, maximize reimbursement rates, and minimize administrative burdens.
• Lead in addressing and resolving disputes or issues with payors.
• Build and lead a team that reviews and processes physician orders and payment claims.
• Collaborate with internal stakeholders, including executive leadership, finance, legal, and operations teams, to align payor strategies with organizational goals and objectives.
• Keep internal stakeholders informed about payor policies, changes, and updates. Ensure that the organization adheres to payor requirements, contracts, and guidelines.
• Collaborate with the finance team to monitor payor contract compliance, track revenue performance, and identify potential financial risks or opportunities.
• Analyze payor data and performance metrics to identify areas for improvement and develop action plans to optimize reimbursement rates and claims processing efficiency.

QUALIFICATIONS:

• Bachelor's degree in healthcare administration, business administration, finance or other related field.
• 8 - 10 years of recent experience of payor enrollment and durable medical equipment (DME) contracting in the medical device industry.
• Comprehensive knowledge of payor enrollment regulations and DME contracting processes.
• Knowledge and understanding of the driving forces in the local, State, and national healthcare markets and the ability to assess emerging trends and needs and develop plans to address such trends.
• Proven success working with State and Federal (Medicare) Healthcare regulations relating to payor contracts, payment guidelines, etc.

Benefits:

Element Science offers a very competitive salary and benefits package including, but not limited to:

• Stock Options
• 90% employer-paid medical, dental, and vision insurance
• Company-paid Basic Life Insurance
• 401(k) retirement plan (Traditional and Roth)
• Competitive Paid Time Off
• Paid Holidays
• FSA (Flexible Spending Accounts)
• HSA (Health Savings Account)
• Employee Assistance Program through PEO
• The salary for this exempt-level position will be based on experience and qualifications within an established pay range