Payor Relations / Contracting Manager
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Position Overview: The Payor Relations / Contracting Manager will be responsible for developing, negotiating, and managing contracts with various payors, including insurance companies, government programs, and other third-party entities. This role requires a strategic thinker with strong analytical skills, excellent negotiation capabilities, and a deep understanding of the healthcare payor landscape.
Key Responsibilities:
Contract Negotiation: Lead negotiations with payors to secure favorable contract terms, including reimbursement rates, payment terms, and service coverage.
Relationship Management: Build and maintain strong, positive relationships with payors to ensure ongoing collaboration and alignment with company objectives.
Contract Management: Oversee the administration of payor contracts, including renewals, amendments, and compliance with contract terms.
Market Analysis: Monitor market trends and changes in the healthcare industry to anticipate and respond to shifts in payor requirements and expectations.
Collaboration: Work closely with internal teams, including finance, legal, and operations, to ensure that contract terms are in line with the companys goals and capabilities.
Issue Resolution: Address and resolve any disputes or issues that arise with payors, ensuring minimal disruption to operations and financial stability.
Reporting: Prepare regular reports on payor relations and contract performance for senior management, identifying areas for improvement and opportunities for growth.
Job qualifications & experience
Bachelors or higher degree in public health, health administration, business administration, public policy or related field.
Payer contracting/relations 5-10+ years
Health care experience 5+ years (preferably behavioral health)
Must be familiar with health care pricing and reimbursement methodologies
Knowledge of network development processes, contract language, principles of negotiation and credentialing
Ability to communicate effectively and work directly with clients, physicians, staff, managers, department heads, health plans and government agencies and community members.
Proficient in Excel / Microsoft Suite
Sales Mindset
What we offer:
Employee Benefits: We understand the importance of a well-rounded benefits package. Thats why were dedicated to providing a range of plans to meet your needs.
For full-time employees, we offer:
HSA and PPO insurance with HSA or FSA options (Blue Cross Blue Shield)
Dental insurance (Delta Dental)
Vision insurance (EyeMed)
Short-term and long-term disability insurance
Company-paid life insurance
401(k) plan available two months after start date
Company 401(k) matching for up to 50% of your contribution, up to 6% of your compensation
Paid time off is a crucial part of maintaining work and life balance. Our generous PTO plan accrues annually and begins with your first whole pay period. Eligible employees enjoy seven paid holidays and one floating holiday in addition to their regular PTO
Apply Now
Position Overview: The Payor Relations / Contracting Manager will be responsible for developing, negotiating, and managing contracts with various payors, including insurance companies, government programs, and other third-party entities. This role requires a strategic thinker with strong analytical skills, excellent negotiation capabilities, and a deep understanding of the healthcare payor landscape.
Key Responsibilities:
Contract Negotiation: Lead negotiations with payors to secure favorable contract terms, including reimbursement rates, payment terms, and service coverage.
Relationship Management: Build and maintain strong, positive relationships with payors to ensure ongoing collaboration and alignment with company objectives.
Contract Management: Oversee the administration of payor contracts, including renewals, amendments, and compliance with contract terms.
Market Analysis: Monitor market trends and changes in the healthcare industry to anticipate and respond to shifts in payor requirements and expectations.
Collaboration: Work closely with internal teams, including finance, legal, and operations, to ensure that contract terms are in line with the companys goals and capabilities.
Issue Resolution: Address and resolve any disputes or issues that arise with payors, ensuring minimal disruption to operations and financial stability.
Reporting: Prepare regular reports on payor relations and contract performance for senior management, identifying areas for improvement and opportunities for growth.
Job qualifications & experience
Bachelors or higher degree in public health, health administration, business administration, public policy or related field.
Payer contracting/relations 5-10+ years
Health care experience 5+ years (preferably behavioral health)
Must be familiar with health care pricing and reimbursement methodologies
Knowledge of network development processes, contract language, principles of negotiation and credentialing
Ability to communicate effectively and work directly with clients, physicians, staff, managers, department heads, health plans and government agencies and community members.
Proficient in Excel / Microsoft Suite
Sales Mindset
What we offer:
Employee Benefits: We understand the importance of a well-rounded benefits package. Thats why were dedicated to providing a range of plans to meet your needs.
For full-time employees, we offer:
HSA and PPO insurance with HSA or FSA options (Blue Cross Blue Shield)
Dental insurance (Delta Dental)
Vision insurance (EyeMed)
Short-term and long-term disability insurance
Company-paid life insurance
401(k) plan available two months after start date
Company 401(k) matching for up to 50% of your contribution, up to 6% of your compensation
Paid time off is a crucial part of maintaining work and life balance. Our generous PTO plan accrues annually and begins with your first whole pay period. Eligible employees enjoy seven paid holidays and one floating holiday in addition to their regular PTO
Apply Now