Payer Contracting Manager

Skilled Wound Care•Los Angeles, CA

2d•Onsite

About The Position

The Payer Contracting Manager is responsible for negotiating, monitoring, and maintaining managed care contracts between the healthcare organization and insurance payers. The role combines negotiation, financial analysis, and relationship management to help ensure reimbursement rates are competitive, financially sustainable, and aligned with changes in value-based care. This is an in-person position at an office in Playa Vista, California.

Requirements

Bachelor’s degree in Healthcare Administration, Finance, Business, or a related field.
At least 5 years of experience in managed care contracting, provider relations, or healthcare reimbursement.
Advanced proficiency in Excel for financial modeling.
Familiarity with medical coding, including ICD-10, CPT, and HCPCS, and with billing software.
Deep understanding of different reimbursement methodologies.
Candidates must complete pre-employment confidential DiSC testing and relevant skills testing.

Nice To Haves

Master’s degree, MHA, or MBA.

Responsibilities

Lead end-to-end negotiations for fee-for-service and value-based care agreements with national and local payers.
Analyze the financial impact of proposed rate changes using internal utilization data and assess return on investment.
Serve as the primary liaison to payer representatives and resolve systemic claims issues or credentialing bottlenecks.
Identify network expansion opportunities and evaluate new at-risk or bundled payment models.
Ensure contracts comply with state and federal regulations, including HIPAA and ERISA, and communicate payer requirements to internal departments.
Manage the contract process from signature through implementation, including execution, scanning, and loading contracts into the billing system.
Monitor industry trends, legislative changes, and competitor pricing.