Job Summary
The Payer Contracts Manager is responsible for the effective oversight and management of payer contracting and the organizations Revenue Integrity function. This role leads contract negotiations in consultation with the Senior Vice President/Chief Financial Officer, analyzes and evaluates payer proposals, and ensures timely renewal and execution of agreements. This position ensures alignment with organizational contracting standards while proactively identifying opportunities to enhance contract performance and strengthen payer partnerships.
Licensure and Certification: N/A
Education: Bachelors degree required; preferably in economics, business, finance, or healthcare. Preferred Masters degree in healthcare economics, healthcare policy, or finance.
Experience: Minimum seven (7) years recent employment in a hospital, medical or healthcare insurance field with experience in the negotiation and management of payer contracts and analytics. Preferred ten (10) years progressive hospital payer contracting experience, Direct payer negation strategy development, Payer relationship management, Management and supervision of Payer Contract Analyst position.
Knowledge and Skills: Required demonstrated knowledge and experience of negotiating and managing payer contracts. Required demonstrated knowledge and experience in using Excel (demonstrating advanced usage of formulas and modeling techniques), hospital billing systems, and other financial software systems, including report writing, that supports review and analysis of financial performance by payer. Demonstrates ability to communicate both verbally and in writing. Demonstrates ability to analyze problematic situations and implement solutions. Customer service skills. Demonstrates experience and knowledge of principles and practices used in the development of payer contracts, contract administration, and negotiation strategies.
Physical Demands - Clerical/Administrative Non Patient Care: Frequent sitting and standing/walking with frequent position change. Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level. Occasional/intermittent reaching at or above shoulder level. Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting, and climbing. Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds. Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.
Key for Physical Demands Continuous: 66 to 100% of the time Frequent: 33 to 65% of the time Occasional: 0 to 32% of the time