Manager Payer Relations

California, CA - USA

Yearly Salary: $ 84852 - 108894

Posted on: 15 hours ago

Vacancies: 1 Vacancy

Job Summary

Job Title: Manager - Payer Relations
Department: Payer Relations & Contracting

About the Role:
We are currently seeking a highly motivated Manager - Payer Relations. This role will report to the SVP - Payer Contracting and enable us to continue to scale in the healthcare industry.

What Youll Do

Owns Health Plan relationships pertaining to day to day issues for all medical groups
Drive root cause solutions
Ensure Proper administration of DOFRs
Oversee and design CAPs arising from Health Plans
Oversee project(s) from Health Plans
RFPs for vendors
Amendments
Routine communication / requests to Health Plans
Project manage all aspects of Payer and Provider contracting
Provide guidance for Payer Relations Associates
Efficiently delegate and coordinate the flow of contracts to all relevant stakeholders
Interpret and assess risk for provider-facing and payer-facing agreements for time sensitive negotiations
Perform Delegation Oversight / Compliance analysis to reduce Astranas risk exposure and likelihood of incurring penalties sanctions and or deductions
Work directly with Claims Configuration Business Development and Data Management teams to gather reports regarding data to support proposal

Qualifications

Bachelors Degree required or equivalent experience in the healthcare industry
Minimum of 2-3 years of contracting / negotiation / payer / provider relations experience in the healthcare industry
Technical backgrounds are a plus with a passion for the healthcare industry

Youre great for this role if:

High level of comfort working with numbers and large bodies of text
Strong problem-solving skills with ability to showcase a methodical approach to troubleshooting
You are meticulous highly organized and able to engage in exhaustive investigation when initial information is vague
Excellent communication skills both verbal and written. Experience in technical writing is a plus
Understands and has experience working within the delegated network environment
Strong comfortability with Microsoft Office Suite (Excel Word PowerPoint)
Very knowledgeable with EZ-Cap and able to understand and work with proprietary software applications preferred

Environmental Job Requirements and Working Conditions

Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly office days will alternate between offices at 600 City Parkway West Orange CA 92868 and 1600 Corporate Center Dr Monterey Park CA 91754.
The total compensation target pay range for this role is: $84852.26 - $108893.73. Actual compensation will be determined based on geographic location (current or future) experience and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran status as an individual with a disability or other applicable legally protected characteristics. All employment is decided on the basis of qualifications merit and business need. If you require assistance in applying for open positions due to a disability please email us at to request an accommodation.

Additional Information:

The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Required Experience:

Manager

Job Title: Manager - Payer Relations Department: Payer Relations & Contracting About the Role: We are currently seeking a highly motivated Manager - Payer Relations. This role will report to the SVP - Payer Contracting and enable us to continue to scale in the healthcare industry. What Youll...