Payer Relations Specialist

Waystar • Louisville, KY

71d

About The Position

The Payer Relations Specialist is responsible for initiatives to identify and build contractual relationships with payers for direct data connections with those payers. As a key member of the Waystar payer relations team, the Payer Relations Specialist will drive new value for Waystar's clients by unlocking new partnerships and capabilities with Insurance Carriers, help improve Waystar's outcomes and lower costs by using payer support connection methods to effectively exchange data with payers, build and sustain high-value networks and create collaborative partnerships with payers. This role positions the organization for sustainable financial performance through sophisticated and innovative payer strategies. This role will report to the Sr Director of Product Operations.

Requirements

• 5+ years industry experience in healthcare organizations
• Must demonstrate a track record of effectively communicating with healthcare organizations
• Dedication to excellence and innovation regarding continuous quality improvement, patient care models and clinical integration
• Knowledge and understanding of the driving forces in the local, state, and national healthcare markets and the ability to assess emerging trends and needs and develop plans to address such trends
• Must possess excellent written, verbal, and listening communication skills and be comfortable and effective in working with all levels of management
• Include evidence and commitment to continuing professional development

Nice To Haves

• Experience with electronic health records (EHRs) and other healthcare technology platforms
• Knowledge of coding and billing practices
• Experience with revenue cycle management including payer relationships
• Strong Excel, Power BI, and PowerPoint experience and skills

Responsibilities

• Identify payer connections needed by Waystar clients and applications
• Self-directed efforts to prospect, build and maintain a new connection pipeline
• Develop and maintain strong relationships with payers, including health insurance companies, managed care organizations, and government agencies
• Create new, mutually beneficial data exchanges that drive value for providers and health insurance companies
• Negotiate contracts and agreements with payers to ensure favorable terms and conditions
• Stay informed about payer policy and procedure changes and implement necessary adjustments
• Identify cost-saving opportunities and implement strategies to improve financial performance
• Track and communicate the status of payer contracting and connections activities
• Execute and manage the company's overall payer strategy to transition to highly effective, secure, and reliable payer connectivity
• Develop strategies to advance payer partnerships and overall efforts to maximize the value of strategic payer partnerships for the organization
• Maintain working knowledge of data exchange standards and technologies to include X12, FHIR, APIs and connection methods used in the industry
• Apply financial and analytic acumen to achieve desired outcomes
• Maintain close working relationships with payers, including joint contracting, planning, and joint ventures
• Responsible for ensuring that established financial and quality goals are achieved
• Maintains productive working relationships

Benefits

• Competitive total rewards (base salary + bonus, if applicable)
• Customizable benefits package (3 medical plans with Health Saving Account company match)
• Generous paid time off for non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays
• Flexible time off for exempt team members + 13 paid holidays
• Paid parental leave (including maternity + paternity leave)
• Education assistance opportunities and free LinkedIn Learning access
• Free mental health and family planning programs, including adoption assistance and fertility support
• 401(K) program with company match
• Pet insurance
• Employee resource groups

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Professional, Scientific, and Technical Services
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees