Payer Contracting Manager

The role

The Payer Contracting Manager negotiates, monitors, and maintains managed care contracts. This role involves financial analysis and strategic relationship management with insurance companies.

What you will do

• Lead end-to-end negotiation for fee-for-service and value-based care agreements.
• Analyze financial impact of rate changes using internal utilization data.
• Act as primary liaison between the organization and payer representatives.
• Identify opportunities for network expansion and evaluate new payment models.
• Ensure contracts comply with state and federal regulations.
• Manage the signature to implementation process for contracts.
• Stay abreast of industry trends, legislative changes, and competitor pricing.

Required qualifications

• Bachelor’s degree in Healthcare Administration, Finance, Business, or a related field.
• 5+ years of experience in managed care contracting, provider relations, or healthcare reimbursement.
• Advanced proficiency in Excel for financial modeling.
• Familiarity with medical coding (ICD-10, CPT, HCPCS) and billing software.
• Deep understanding of different reimbursement methodologies

Nice to have

• Master’s degree/MHA/MBA

Benefits

• Paid vacation days
• Health insurance
• Retirement plans

Before you apply

• Perform pre-employment confidential DiSC testing.
• Perform appropriate relevant skills testing prior to hiring.

About the company

Skilled Wound Care is an equal opportunity employer.