Payer Contract Manager

Job Summary:

This position is responsible for supporting the System Contracting department by providing payer contracting subject matter expertise and performing special projects as determined by the Vice President of System Contracting and the Director of Managed Care Contracting. Assignments would include providing consultation on, leading and/or performing complex payer negotiations, financial model development, analytics, and cross-functional system projects and initiatives.

Job Responsibilities:

• Serve as project manager and execute assigned projects. Projects will include complex cross-functional strategic initiatives and payer negotiations.

• Perform analytical functions to evaluate contract performance of fee-for-service and value-based contract terms to support payer negotiations, collaborating with payors and system colleagues as needed.

• Serve as subject matter expert on payer contract terms, payer relationships and strategies, fee-for-service reimbursement terms and value-based financial models. Provide consultation to and educate others within the organization on such subject matter.

• Support strategic initiatives as assigned, including leading or supporting cross-functional teams to drive improved performance and evaluate opportunities.

• Effectively coordinate and collaborate with System Contracting and other areas within the organization including Primary Health, Reimbursement, Revenue Cycle, Finance, and Analytics.

• Prepare and present deliverables for executive leaders.

• Effectively manage multiple projects and assignments occurring at the same time.

• Perform other responsibilities or assignments as required.

Skills:

Required Skills & Experience:

• Minimum ten (10) years of experience in the healthcare industry.

• Minimum seven (7) years of experience in Payer Contracting, with at least three (3) years of experience with value-based contracting terms.

• Comprehensive project management abilities.

• Excellent oral and written communication and presentation skills.

• Excellent organizational skills and ability to manage multiple projects simultaneously.

• Excellent interpersonal skills and ability to develop effective working relationships with both internal and external customers.

• Strong negotiation skills.

• Understanding of legal, business, and insurance operations principles.

• Proficient in Microsoft Word, Excel, and PowerPoint.

• Must meet or exceed core customer service responsibilities, standards, and behaviors as outlined in the Client’s Customer Service Policy and summarized below:

  • Communication
  • Ownership
  • Understanding
  • Motivation
  • Sensitivity
  • Excellence
  • Teamwork
  • Respect

• Must practice the customer skills as provided through ongoing training and in-services.

• Must possess the following personal qualities:

  • Be self-directed.
  • Be flexible and committed to the team concept.
  • Demonstrate teamwork, initiative, and willingness to learn.
  • Be open to new learning experiences.
  • Accept and respect diversity without judgment.
  • Demonstrate customer service values.

Preferred Skills & Experience:

Schedule Notes:

Direct Placement Opportunity - 20% finders fee based on estimated yearly salary.

REQUIRED

• Bachelors Degree in Accounting, Finance, or related field (Masters degree preferred).
• Minimum 10 years experience in the healthcare industry.
• Minimum 7 years experience in Payer Contracting, with at least 3 years of experience with value-based contracting terms.
• Extensive Project Management experience.
• Excellent communication and presentation skills.
• Excellent organizational skills.
• Excellent interpersonal skills.
• Understanding of legal, business, and insurance operation principles.
• Strong negotiation skills.
• Proficiency in Microsoft Word, Excel, and PowerPoint.