Payor Contract Manager - Remote

Responsibilities

• Responsible for achieving prioritized contracting targets for market.
• Collaborates with director and payor contracting to achieve regional/market goals and contract targets.
• Accountable for a service line strategy (e.g., home health, hospice, personal care or ACO), including understanding and informing standard rate logic, language, and business requirements to inform and influence portfolio strategies.
• Ensures successful execution of projects for the payor contracting team including, but not limited to, payor contracting initiatives that are associated with global contract/coding updates and merger/acquisition activity.
• Completes contracting efforts associated with addition/termination of locations/markets.
• Vets and prioritizes requests for new contracts.
• Preps initial due diligence documentation and recommended action plan for regional leadership team/director/senior vice president as required.
• Conducts market research to proactively identify risks/opportunities to inform market strategies.
• Maintains relationships with vendors, payors and other third parties in order to enhance strategic relationships.
• Maintains database and related contracting information system payor files for accurate and timely claims processing.
• Performs other duties as assigned.

Qualifications

• Bachelor's degree in business or related field.
• Five years of experience in managed care contracting and contract-related accountabilities in or around home health, hospice, health plan or large health care system.