Full-Time

Director – Strategic Payor Partnerships

Posted on 11/16/2024

Cerebral

Cerebral

501-1,000 employees

Online mental health services subscription provider

Healthcare

Compensation Overview

$170k - $195kAnnually

+ Annual Bonus + Equity/Stock Options

Senior

Remote in USA

Category
Business Development
Business & Strategy
Requirements
  • Bachelor's degree in Business Administration, Healthcare Administration, or related field; Master's degree preferred.
  • Minimum of 7 years of experience in insurance management, strategic partnership development, business development, or related roles within the healthcare industry.
  • Deep understanding of the healthcare insurance landscape, including knowledge of payer dynamics, reimbursement models, and regulatory requirements.
  • Proven track record of building and managing successful partnerships with insurance providers.
  • Understanding of the full patient insurance lifecycle, including eligibility and benefit verification, claims submission, and claims processing.
  • Experience in payer contract negotiations and management, especially with major networks such as BCBS, Cigna, Aetna, Magellan, and UHC.
  • Interpretation of CMS EDI Standards: Knowledge in interpreting CMS EDI standards, such as EDI 270/271.
  • Experience with working with Mental Healthcare carveout programs for insurance eligibility and billing.
  • Experience working with Health Insurance Technology and vendors, including experience with Real-Time eligibility, Automatic Claims processing, and workflow optimization.
  • Experience with clinician credentialing and delegation agreements.
  • Strong negotiation skills, with the ability to structure and execute complex partnership agreements.
  • Strategic thinker with the ability to identify and capitalize on market opportunities.
  • Excellent communication and interpersonal skills, with the ability to effectively engage and influence internal and external stakeholders.
  • Strong analytical skills, with the ability to analyze market trends, financial data, and performance metrics to drive decision-making.
  • Leadership experience, with the ability to lead cross-functional teams and drive results in a dynamic, fast-paced environment.
  • Demonstrated ability to thrive in a fast-paced, dynamic environment and adapt to changing priorities.
Responsibilities
  • Lead the development and execution of a comprehensive partnership strategy to drive growth and enhance Cerebral's market position within the Insurance space. Identify opportunities for contracts with insurance providers aligned with business objectives.
  • Cultivate and maintain strong relationships with insurance providers, including payers, health plans, and managed care organizations. Serve as the primary point of contact for key partners, establishing new contracted coverage, and fostering collaboration and alignment on strategic initiatives.
  • Lead negotiations with insurance providers to establish mutually beneficial partnership agreements. Collaborate with legal and finance teams to structure agreements that support Cerebral’s growth objectives, while mitigating risks.
  • Develop and implement initiatives to drive revenue growth through strategic insurance partnerships. Identify opportunities to expand product offerings, increase market share, and generate new revenue streams in collaboration with insurance partners.
  • Conduct market research and analysis to identify emerging trends, opportunities, and threats in the insurance landscape. Develop a strong understanding of competitor offerings and customer preferences. Utilize insights to inform strategic decision-making, product development initiatives, and to optimize partnership strategies.
  • Partner closely with cross-functional teams, including product development, marketing, finance / billing, and operations, to ensure alignment of partnership initiatives with overall business goals. Collaborate on product development, go-to-market strategies, and client engagement efforts.
  • Track and evaluate the performance of insurance partnerships against established KPIs and objectives. Act as a liaison between Cerebral and insurance partners to resolve issues and drive mutual success.
  • Collaborate with finance and revenue cycle management teams to optimize insurance reimbursement processes and maximize revenue generation. Identify opportunities to optimize claims efficiency and minimize errors for revenue enhancement and cost containment.
  • Work with legal and compliance teams to stay abreast of regulatory changes and industry standards pertaining to insurance practices.
  • Lead cross-functional team working on our insurance 'relaunch,' providing project management, expectation setting, and team development to support the launch. Foster a collaborative and inclusive team culture focused on continuous improvement and excellence.
  • Experience in start-ups or ability to move quickly despite insurance being a traditional industry.

Cerebral provides online mental health services that focus on making mental health care accessible and affordable. The company connects individuals with licensed therapists and prescribers through a subscription model, allowing users to pay a monthly fee for ongoing support. Customers can book and reschedule sessions via an app, and they also have the option to receive medication either delivered to their home or available for pickup at a pharmacy. Cerebral differentiates itself from competitors by offering a comprehensive package that combines therapy and medication, which has been shown to significantly reduce the chances of major depression recurring. The goal of Cerebral is to provide flexible and personalized mental health care to individuals seeking support.

Company Stage

Series C

Total Funding

$449.4M

Headquarters

San Francisco, California

Founded

2020

Growth & Insights
Headcount

6 month growth

-11%

1 year growth

-28%

2 year growth

-56%
Simplify Jobs

Simplify's Take

What believers are saying

  • The recent $300M Series C funding round led by SoftBank Vision Fund 2 positions Cerebral for significant growth and service expansion.
  • Hiring high-profile figures like Simone Biles as Chief Impact Officer enhances the company's visibility and credibility in the mental health sector.
  • Cerebral's flexible and affordable subscription model can attract a wide range of customers, potentially leading to a large and loyal user base.

What critics are saying

  • The highly competitive digital health market requires Cerebral to continuously innovate to maintain its edge.
  • Dependence on subscription fees means that customer retention is crucial; any decline in user satisfaction could impact revenue.

What makes Cerebral unique

  • Cerebral's entirely online platform makes mental health services accessible to a broad audience, unlike traditional in-person therapy models.
  • The subscription-based model with various pricing tiers, including a discounted 'Strong Start' package, offers flexibility and affordability, setting it apart from competitors.
  • Cerebral's combination of therapy and medication plans provides a comprehensive approach to mental health care, which is supported by research indicating high effectiveness.

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Benefits

Remote-first

Medical, dental, vision, & life insurance

401k

Unlimited PTO

Wellness stipend

Bi-quarterly mental health days

No-Meeting-Wednesdays

Social events

Optional company retreats