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Manager, Payer Contracting
Location
California
Posted
1 day ago
Salary
0
Seniority
Senior
Job Description
Manager, Payer Contracting
Salinas Valley Health
• Promote and manage all managed care contracting efforts on behalf of the hospital and clinics • Responsible for assisting with all payer contracting • Negotiate, implement, and maintain all payer contracts and the respective policies for each • Keep abreast of all managed care marketplace activities and adjust strategies accordingly • Accountable for the negotiation, implementation, and contract performance tracking of all managed care contracts for the health system • Review and analyze contract language, including reimbursement methodologies and fee schedules • Maintain the centralized contract repository and ensure version control • Ensure contracts comply with federal and state regulations and partner with internal and external Legal teams to review terms to mitigate risk • Serve as the primary liaison between the organization and payer representatives • Support operational teams with contract interpretation and issue resolution • Identify and negotiate supplemental payments • Track key contract metrics including payer mix, expiration/renewal dates, and reimbursement rates • Lead and maintain collaborative payer and employer relationships
Job Requirements
- Bachelor’s degree required
- Three (3) years’ experience in managed care contracting
- Experience working with Epic
- Experience working with contract management software
- Knowledge of California and Federal rules related to managed care contracting, billing and compliance
- Knowledge of population health and total cost of care
- Proficient in Microsoft Office applications, including Excel, PowerPoint and Word
- Excellent skills in dealing with members of the public, patients and co-workers by utilizing positive communication, both written and verbal
Benefits
- None
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