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. Lead negotiations with insurance companies to secure favorable payer contracts. Analyze the potential impact of contract renegotiations and build a compelling business case to justify rate increases. Oversee the development and implementation of analytics strategies to derive actionable insights from complex healthcare data. Build and maintain strong relationships with key payer stakeholders. Leverage your negotiation skills to negotiate rate increases with insurance companies, ensuring mutually beneficial agreements. This role requires a strong background in healthcare analytics and payer contracting.

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, ensuring optimal terms for both parties
• Analyzes 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
• Negotiation with Insurance Companies: Leverage your relationships and negotiation skills to negotiate rate increases with insurance companies, ensuring mutually beneficial agreements for all stakeholders
• Reimbursement research
• 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

Benefits

Work Set up - Remote