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Payer Relations and Contracting Process Manager

Hiring from
United States
Work type
Remote
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  • Location: Remote
  • Department: Revenue Cycle Contracting Managed Care
  • Schedule: Day Shift | Full-Time
  • Contract Negotiation & Redlining: Manage contract reviews and redlines, supporting negotiation initiatives of various scopes across the organization to align with government managed care goals.
  • Financial Modeling & Analytics: Analyze and interpret data to support negotiation strategies and improve revenue performance.
  • Relationship & Vendor Management: Act as the primary external relationship manager with commercial and government payers (including population health initiatives to optimize spend) as well as internal teams, and key vendor partners.
  • Performance Reporting & Portfolio Review: Develop comprehensive reporting solutions to track financial and operational contract performance, presenting actionable evaluations and recommendations for contract renewals, renegotiations, or terminations.

Education:

  • High School diploma equivalency with 3 years of cumulative experience OR Associate's degree/Bachelor's degree with 2 years of cumulative experience OR 7 years of applicable cumulative job specific experience required. 3 years of leadership or management experience preferred.

Additional Preferences:

  • 3–5 years of hands-on experience in managed care contracting, contract redlining, payer/provider relations, and navigating state/federal regulatory environments (e.g., Medicare, Medicaid, Exchange).
  • Proven capability managing cross functional and payer/ provider relationships, paired with strong proficiency in contract negotiations.

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