Manager of Payer Contracting (Healthcare)

Location: United States - Remote; remote work is available, with an option to work from the headquarters in Des Moines, Iowa.

Company

Telehealth solutions support go-to-market care delivery and virtual patient care across a broad range of specialties in all 50 states.

What you will do

• Acquire, coordinate, analyze, and manage group-level payer contracts, including delegated contracts where applicable.
• Negotiate fee schedules and reimbursement terms for new and existing contracts.
• Coordinate contract implementation and reviews with Payer Enrollment, Revenue Cycle Management, Billing/Coding, Finance, IT, and Clinical Operations.
• Develop fee schedules with Revenue Operations using financial models and payer rate analysis.
• Monitor renewals, renegotiate contracts, maintain payer relationships, and resolve escalated contract issues.
• Analyze payer mix and rate structures, maintain billing database knowledge, and manage special projects.

Requirements

• Bachelor’s degree.
• 4+ years of managed care contracting experience in a provider or payer setting.
• Extensive knowledge of payer reimbursement and analytical modeling, including value-based contracting.
• Knowledge of Medicare, Medicaid, managed care organization, and commercial payment methodologies.
• Understanding of provider contracting, financial arrangements, fee schedules, claims processing systems, and applicable policies and regulations.
• Proficiency with GSuite, payer portals, provider data management systems, billing databases, and business software; experience with MDStaff, Medallion, Verisys, Jira, ZenDesk, or Zoho Desk is relevant.

Culture & Benefits

• Medical, dental, and vision plans.
• Flexible Spending Accounts and Health Savings Accounts.
• Flexible paid time off.
• 401(k) with company match.
• Life insurance, pet insurance, and additional benefits.
• Flat organizational structure emphasizing autonomy, competence, belonging, and employee-driven ideas.