Job Description
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:
- N/A
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:
- 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.