Payer Contracts Manager

Qualifications

• Bachelor’s degree in healthcare administration, business, finance, or a related field required; advanced degree preferred.
• Five or more years of experience in managed care contracting, payer relations, network development, reimbursement, or a related healthcare function.
• Direct experience negotiating and managing contracts with California IPAs and delegated medical groups is required.
• Established knowledge of California managed care landscape and common IPA contracting structures.
• Strong understanding of delegated arrangements, divisions of financial responsibility, risk-based and fee-for-service reimbursement, authorization requirements, claims processes, and dispute-resolution provisions.
• Experience negotiating and administering agreements with commercial and government-sponsored health plans.
• Strong understanding of healthcare reimbursement methodologies, fee schedules, contract structures, and managed care terminology.
• Strong project-management skills and the ability to manage multiple contracts, deadlines, and competing priorities.
• Experience in infusion therapy, specialty pharmacy, ambulatory healthcare, or another specialty provider environment is strongly preferred.
• Experience supporting payer contracting across multiple states is preferred.

Compensation

• Base Salary : $150,000 - $165,000

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