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Manager, Payor Relations and Contracting

Hunterdon Health
Flemington, NJ Full Time
POSTED ON 2/4/2025
AVAILABLE BEFORE 5/4/2025

NOTE - This Position is Hybrid with a minimum of three days on site per week

Job Description :

Under the direction of the Director of Managed Care Contracting and Provider Relations, this individual is responsible for managing the payor contracting functions for Hunterdon HealthCare Partners.

Major Responsibilities

  • Craft, evaluate, negotiate and execute a wide variety of different contracts covering a

range of transactions for hospital and physician entities.

  • Create and maintain relationships with external stakeholders (payers) and internal
  • stakeholders (billing, finance, legal, physicians, administration).

  • Maintain records for correspondence and documentation in relation to established
  • contracts and those in progress; ensure contract library remains current.

  • Communicate and present information to stakeholders about all contract-related
  • matters.

  • Solve any contract-related problems that may arise with other parties and internally
  • with the company itself; this includes tracking and monitoring data as it relates to

    outstanding settlements / projects for payer payment issues.

  • Manage and maintain reporting regarding payor trends, contract compliance and
  • contract modeling.

  • Manage existing contracts to ensure negotiated rates are achieved.
  • Routinely evaluate current contracts for appropriate reimbursement terms and
  • renewals to ensure compliance with industry standards.

  • Resolve provider enrollment issues with contracted payers.
  • Skills and Abilities

  • Four to seven years' experience in responsible positions in healthcare or health plan
  • environment, with financial and managed care contracting experience.

  • The individual must have experience in the negotiating / contracting process including a
  • strong ability to organize and prioritize activities while ensuring attention to details.

    Education Requirements

  • Bachelors degree in Business or a related field and five (5) years of related experience
  • required.

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