Remote Payor Relations Manager, Senior Analyst

Summary

Join our dynamic team as a Payor Relations Manager/Senior Analyst, where you will play a crucial role in shaping and optimizing our payer relationships. As a seasoned professional in the healthcare industry with a passion for strategic negotiation and analytics, you will lead negotiations with insurance companies to secure favorable payer contracts, analyze potential impact of contract re-negotiations, develop analytical platforms, build business cases, oversee analytics strategies, manage relationships with key payer stakeholders, negotiate rate increases, collect and interpret reimbursement data, research payor behavior trends, and provide analysis to the Business Development/Sales Team.

Requirements

• Bachelor's degree in healthcare administration, Business, or a related field; master's degree preferred
• Minimum of 3-5 years of experience in payer contracting, with a focus on negotiation and analytics
• Proven track record in building and implementing analytical platforms
• Strong experience in crafting persuasive business cases
• In-depth knowledge of healthcare analytics and negotiating with insurance companies

Responsibilities

• Lead negotiations with insurance companies to secure favorable payer contracts
• Analyze the potential impact of contract re-negotiations by building proposed rates into the Contract Management System and modeling the financial impact
• Spearhead the development of analysis to build a compelling business case to justify rate increases with Payers
• Utilize your experience in building robust business cases to support and guide key organizational decisions
• Oversee the development and implementation of analytics strategies to derive actionable insights from complex healthcare data
• Build and maintain relationships with key payer stakeholders and organizations
• Leverage your relationships and negotiation skills to negotiate rate increases with insurance companies, ensuring mutually beneficial agreements for all stakeholders
• Collect, organize and interpret reimbursement data for CMS1500 and UB for billing
• Research and coordinates with compliance for Revenue Cycle requirements for facility and non-facility operations
• Provide feedback to Revenue Cycle for opportunities at financial improvement
• Analyze payor behavior trends across the nation on a facility/non facility and state-wide scale
• Examine outside data from prospective clients and provide analysis to the Business Development/Sales Team