Manager - Payer Relations

Astrana Health, Inc.•Monterey Park, CA

9h•$84,852 - $108,894•Onsite

About The Position

We are currently seeking a highly motivated Manager - Payer Relations. This role will report to the SVP - Payer Contracting and enable us to continue to scale in the healthcare industry.

Requirements

Bachelor’s Degree required or equivalent experience in the healthcare industry
Minimum of 2-3 years of contracting / negotiation / payer / provider relations experience in the healthcare industry
Technical backgrounds are a plus with a passion for the healthcare industry
High level of comfort working with numbers and large bodies of text
Strong problem-solving skills with ability to showcase a methodical approach to troubleshooting
You are meticulous, highly organized, and able to engage in exhaustive investigation when initial information is vague
Excellent communication skills – both verbal and written. Experience in technical writing is a plus
Understands and has experience working within the delegated network environment
Strong comfortability with Microsoft Office Suite (Excel, Word, PowerPoint)
Very knowledgeable with EZ-Cap and able to understand and work with proprietary software applications – preferred

Responsibilities

Owns Health Plan relationships pertaining to day to day issues for all medical groups
Drive root cause solutions
Ensure Proper administration of DOFRs
Oversee and design CAPs arising from Health Plans
Oversee project(s) from Health Plans
RFPs for vendors
Amendments
Routine communication / requests to Health Plans
Project manage all aspects of Payer and Provider contracting
Provide guidance for Payer Relations Associates
Efficiently delegate and coordinate the flow of contracts to all relevant stakeholders
Interpret and assess risk for provider-facing and payer-facing agreements for time sensitive negotiations
Perform Delegation Oversight / Compliance analysis to reduce Astrana’s risk exposure and likelihood of incurring penalties, sanctions, and or deductions
Work directly with Claims, Configuration, Business Development, and Data Management teams to gather reports regarding data to support proposal