Payer Contracting and Relations Manager (Atwater)

Available Staff Positions•Atwater, CA

8d•Hybrid

About The Position

The Payer Contracting and Relations Manager serves as the primary liaison between the organization and payer representatives, addressing operational issues, resolving disputes, and maintaining positive ongoing relationships. The role develops, negotiates, and manages contracts with third-party payers to support optimal reimbursement rates and strong 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. The annual salary range is $85,924–$94,516. The manager leads payer contract negotiations and administration, oversees payer credentialing and enrollment, resolves escalated payer issues, and analyzes contract terms and financial performance. The role collaborates with executive leadership and internal teams on payer strategy, contract alignment, regulatory and policy updates, and operational efficiency. It also tracks payer performance indicators, prepares reports, and presents contract performance metrics to leadership. The work is primarily indoors in an office setting with quiet-to-average noise levels. Daily use of general office equipment is required, and travel may be required at times. Physical demands include occasional lifting of up to 25 pounds and rare pushing of up to 50 pounds on wheels. The employee must be able to hear and speak clearly for phone and in-person communication and have adequate vision, with or without lenses, to read documents and computer screens.

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.

Responsibilities

Lead the end-to-end contract negotiation process with payers, including Medicare, Medi-Cal, and Managed Care plans.
Ensure contracts comply with state, federal, and healthcare regulations.
Manage the signature-to-implementation process, including contract execution, applicable billing-system updates, and communication to appropriate departments.
Identify opportunities for network expansion and evaluate the feasibility of at-risk or bundled payment models.
Monitor industry trends, legislative changes, and competitor pricing.
Maintain comprehensive records of payer contracts, terms, and renewal timelines.
Manage and 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 to develop payer strategies aligned with organizational goals and identify improvement opportunities.
Track payer trends, policy changes, and regulatory updates and communicate their impacts across the organization.
Collaborate with internal teams to support contract alignment, adherence to payer requirements, and operational efficiency.
Participate in audits, appeals, and escalations related to payer issues 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.