Payer Contracting and Relations Manager (Atwater)

Golden Valley Health Centers•Atwater, CA

9d•$85,924 - $94,516•Hybrid

About The Position

The Payer Contracting and Relations Manager serves as the primary liaison between the organization and payer representatives, resolving operational issues and disputes while maintaining positive relationships. The role develops, negotiates, and manages third-party payer contracts to support optimal reimbursement and strategic partnerships. The position is based at the Atwater Admin office, with the possibility of hybrid work once the employee is acclimated to the duties. The schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m. Compensation is $85,924–$94,516 annually.

Requirements

Demonstrated experience negotiating contracts and managing payer relationships.
Strong knowledge of reimbursement methodologies.
Knowledge of healthcare regulations and compliance requirements.
Strong understanding of government programs such as Medicare and Medi-Cal.
Experience with population health initiatives.
Proficiency in healthcare analytics and reporting.
Ability to communicate clearly and concisely orally and in writing.
Ability to interpret contracts and financial data and translate data into actionable summaries for internal stakeholders.
Proficiency in Excel and other Microsoft tools.
Strong problem-solving and conflict-resolution abilities.
Ability to manage multiple contracts and deadlines simultaneously.
High school diploma or equivalent.
Bachelor's degree in Healthcare Administration, Finance, Business Administration, or a related field, or five years of related experience in lieu of a degree.
Three years of progressive experience in payer contracting, provider relations, or healthcare finance.

Nice To Haves

Federally Qualified Health Center (FQHC) experience preferred.

Responsibilities

Lead end-to-end contract negotiations with payers, including Medicare, Medi-Cal, and Managed Care plans.
Ensure contracts comply with state, federal, and healthcare regulations.
Manage contracts from signature through implementation, including execution, applicable billing-system updates, and communication to appropriate departments.
Identify network-expansion opportunities and assess the feasibility of at-risk or bundled payment models.
Monitor industry trends, legislative changes, and competitor pricing.
Maintain comprehensive payer contract terms and renewal timelines.
Strengthen payer relationships and serve as the primary liaison with payer representatives.
Work with health plans to resolve systemic issues and credentialing bottlenecks.
Resolve escalated payer issues, including claims disputes, denials, and operational concerns.
Manage payer credentialing and enrollment processes.
Analyze contract terms, reimbursement rates, and financial performance to optimize revenue and reduce risk.
Collaborate with executive leadership on payer strategies aligned with organizational goals and identify improvement opportunities.
Track payer trends, policy changes, and regulatory updates, and communicate impacts across the organization.
Collaborate with internal teams to support contract alignment, payer-requirement adherence, and operational efficiency.
Participate in audits, appeals, and payer-related escalations as needed.
Prepare reports and present contract-performance metrics to leadership.
Track key performance indicators related to payer performance and reimbursement.
Perform other projects or duties as assigned.