As a Manager for the Payer Relations team, you will be responsible for developing and maintaining relationships with key internal and external stakeholders, negotiating pricing and drafting agreement terms, drafting policies and procedures, conducting root cause analysis, and ensuring compliance with regulatory requirements and industry standards. To excel in this position, you will need to have experience managing and overseeing aspects of payer operations and contracting.

Responsibilities:

• Manage credentialing by overseeing the credentialing function for both payer and facility enrollment for 130 plus providers
• Cultivate and maintain positive relationships with payers
• Implement pricing strategies to optimize reimbursements
• Ensure effective communication between the company, clinicians and stakeholders
• Collaborate with Revenue Cycle leadership to ensure compliance with billing requirements

Qualifications

• 4 plus years of payer relations and reimbursement experience within a relevant industry
• Deep knowledge of healthcare, marketing, managed care strategy, pricing and the medical reimbursement environment required
• Prior strategic account management responsibilities or equivalent relationship development or consulting experience with one of the following: payers, government agencies, IDNs, Accountable Care Organizations (ACOs)
• Knowledge of contracting and credentialing
• Expertise in contract building blocks value based and fee for service
• Excellent time management and multitasking skills
• Proven ability of successfully managing complexity, solving problems, and building strong relationships