Payer Relations Contracting Specialist
About The Position
Responsible for developing, negotiating, implementing, and maintaining payer contracts including but not limited to commercial, Medicare Advantage, Medicaid, and employer health plan contracts. This position would report to the RCM Director and work closely with third-party contracting specialists, finance, credentialing, and development teams, as well as executive management to maximize reimbursement while maintaining strong payer relationships. This position is based out of our Lawrenceville administrative office and is structured as a hybrid role. Remote opportunities may be considered for highly qualified candidates.
Requirements
- Relationship management.
- Project management.
Nice To Haves
- Financial analysis.
- Contract interpretation and negotiation.
- Advanced Excel and data analysis skills.
- 5–10+ years of healthcare contracting experience negotiating with major commercial payers, preferably within a multi-state practice or ambulatory surgery center (ASC) setting.
Responsibilities
- Identify contracting opportunities with commercial insurers.
- Oversee third-party contracting services, negotiating reimbursement rates and contract language.
- Analyze fee schedules and reimbursement methodologies.
- Model the financial impact of proposed agreements with the assistance of third-party analysts.
- Maintain relationships with payer provider representatives.
- Coordinate with provider credentialing and network enrollment teams.
- Manage contract renewals and renegotiations.
- Track contract expiration dates and required notice periods.
- Review policy updates for potential amendments.
- Prepare reports and recommendations for executive leadership.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
