Payor Relations & Contracting Manager
Core
Develops and maintains strategic relationships with physician partners across the Northern Ohio market, leading contract management and provider relations initiatives for Commercial and Medicare lines of business.
Role type
Manager of Contract Negotiation and Provider Relations
Builds
Provider networks and strategic contracts
Domain
Health insurance / Healthcare administration
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Contract negotiation, provider relationship management, competitive analysis, reimbursement strategy, cost analysis, network development, stakeholder partnership
Preferred skills
Provider contract negotiation, provider relations, EPDB, SCM, Provider Data Management, Commercial and Medicare business lines
Technologies
EPDB, SCM
Responsibilities
Lead development and execution of innovative contract negotiation programs; Anticipate industry changes and formulate strategic responses; Design systems to recruit providers for network expansion; Conduct competitive analyses to inform reimbursement strategies; Foster cross-functional collaboration to enhance provider compensation methodologies; Recommend strategies to address cost challenges and drive cost-saving initiatives; Support network development, maintenance, and optimization; Mentor colleagues on best practices and processes.
Seniority
Manager, individual contributor