Job Summary
The Payer Contracts Manager is responsible for the effective oversight and management of payer contracting and the organization’s 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:
Education:
- Bachelor's degree required; preferably in economics, business, finance, or healthcare.
- Preferred Master’s 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:
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 |