Payer Contracting Manager

Skilled Wound Care•Los Angeles, CA

6d•$83,000 - $98,000•Onsite

About The Position

The Payer Contracting Manager serves as the primary architect of the financial relationship between a healthcare provider and insurance companies. The role combines negotiation, financial analysis, and strategic relationship management. The manager negotiates, monitors, and maintains managed care contracts to ensure reimbursement rates are competitive, fiscally sustainable, and aligned with market shifts toward value-based care. This is an in-person position at the 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.

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 to assess return on investment.
Serve as the primary liaison with payer representatives to resolve systemic claims issues and credentialing bottlenecks.
Identify network expansion opportunities and evaluate the feasibility of at-risk and 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, ensuring contracts are executed, scanned, and loaded into the billing system.
Monitor industry trends, legislative changes, and competitor pricing.