Payor Relations Manager/Senior Analyst

Summary

Join our dynamic team as a Payor Relations Manager/Senior Analyst and play a crucial role in shaping and optimizing our payer relationships. You will lead negotiations with insurance companies, develop analytical platforms, build compelling business cases, and oversee analytics strategies. This role requires strong negotiation and analytical skills, experience in payer contracting, and in-depth knowledge of healthcare analytics. The position is located in Chicago, IL, and offers a remote/onsite work setup. A Bachelor's degree in a related field and 3-5 years of experience are required; a Master's degree is preferred.

Requirements

• Bachelor's degree in healthcare administration, Business, or a related field
• 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, ensuring optimal terms for both parties
• 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
• 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

Preferred Qualifications

Master's degree

Benefits

Remote/Onsite work setup