Director, Payer Relations (32413)

The GI Alliance Management LLC Company • $110K — $130K *
Southlake, TX 76092In-Person
Healthcare
5 - 7 years of experience
Today
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Job Overview by Ladders

Qualifications

  • 5 years of healthcare experience, including 3 years in managed care organizations
  • Direct experience negotiating contracts with payors
  • Strong knowledge of payor contract language and operations
  • Proven success in collaboration with payors
  • Understanding of healthcare provider operations
  • Willingness to travel up to 10% of the time

Responsibilities

  • Support the Executive Director in managing payer agreements throughout their lifecycle
  • Negotiate favorable contract terms that align with financial needs
  • Resolve complex issues related to reimbursement, authorizations, and appeals
  • Foster collaborative relationships with internal teams to streamline payer issue resolution
  • Contribute to the strategic direction of the department by analyzing payer rates and market dynamics
  • Maintain organized records of managed care payer contracts in a centralized location
  • Educate internal staff on contract terms and updates

Benefits

  • Collaborative work environment with cross-functional teams
  • Opportunity to influence strategic decisions within the organization
  • Professional development through continuous education and training
  • Engagement in challenging negotiations within a dynamic healthcare landscape
Full Job Description
GI Alliance is seeking an experienced Director of Payer Relations.

Duties of this position include, but are not limited to, the following:

Responsibilities:
  • This position is responsible for supporting the Executive Director in the contractual life cycle of assigned payer agreements via the negotiation, renegotiation, monitoring and maintenance of the paper and the development and management of associated payer contact relationships.
  • This position has a strong understanding of payer contract language and supports negotiations to yield favorable contractual terms and rates in alignment with organizational business and financial needs
  • The Director, Payer Relations navigates, researches, and resolves complex payer issues related, but not limited to, system loads, reimbursement, authorizations, appeals, and recoupments
  • This position develops strong internal collaborative relationships with operational, clinical, legal, and financial partners to achieve efficient, effective, and long-term resolution of payer issues
  • The Director, Payer Relations contributes to the overall strategic direction of the department through an understanding of payer rates and reimbursement structure and associated impact to overall financial performance, payer market dynamics and market share, and how payers acquire and are awarded new business across all financial classes
  • Monitors, and maintains all managed care payer contracts in a transparent, centralized location that is accessible
  • Works collaboratively with key internal and external stakeholders to coordinate communication of contract terms and provisions
  • Completes education and training to various internal parties, including administrative and clinical staff, regarding new or updated contract requirements
  • Reviews single case agreement terms, conditions, and rates for leadership approval
  • Monitors payer scorecards and/or other reporting mechanisms to monitor overall payer performance
  • Assists in payer dispute resolution projects, settlements, RCM and credentialing requested as needed
  • Performs other duties and projects as assigned
  • Demonstrates initiative to continually enhance understanding of the changing healthcare market by state and local regions
  • Exhibit's ability to work independently and is self-directed

Qualifications:
  • 5 years healthcare experience, including 3 years of managed care experience in a managed care organization
  • Experience negotiating contracts directly with Payors required
  • Strong payor contract knowledge required, previous payor operations experience is ideal
  • Demonstrated success in working with Payors required
  • Knowledgeable of healthcare provider operations
  • Must be able to travel up to 10% of the time

No phone calls or agencies, please.

NOTE: ALL APPLICATIONS MUST BE COMPLETED IN FULL FOR CONSIDERATION.

No phone calls or agencies, please.

About The GI Alliance Management LLC Company

GI Alliance Management LLC Careers

There has never been a better time to join the team at GI Alliance Management LLC, a leader in gastrointestinal services. This company stands as a beacon of innovation and leadership in the healthcare sector.

Work You’ll Do

Join GI Alliance Management LLC's top-tier team to assist in transforming the landscape of gastrointestinal health services. This company leads with a commitment to excellence and a strategy focused on digital and medical innovation. Transform healthcare services with the brightest minds at GI Alliance Management LLC. This company holds a unique position in the marketplace, at the crossroads of healthcare expertise, technology, and transformative leadership. Engage with a professional team dedicated to advancing healthcare through cutting-edge technology and patient-centered care. Collaborate with the largest network of gastrointestinal health experts – a team dedicated to pioneering advancements in the field.

Introducing the GI Alliance Management LLC Professional Development Program

The team is building a market-leading program to ensure that all members master their skills in healthcare management and patient care, utilizing the latest in medical technology and practice management.

Do Innovative Work

Be part of a team that delivers targeted healthcare solutions through a depth and breadth of medical expertise and innovation that’s second to none.

Do Innovative Work

Engage in work that pushes the boundaries of traditional healthcare, providing solutions that enhance patient outcomes and streamline operations.

Be Part of a Great Team

Work within a diverse team that values leadership and teamwork, harnessing a wide range of medical technology and knowledge to improve patient care.

Future-proof Your Career

Advance your career with GI Alliance Management LLC, where the opportunities for growth and professional development are abundant. Benefit from unmatched training, development, and certification support.

Explore

Discover how GI Alliance Management LLC is leading the way in predictive healthcare management and patient care excellence.

The GI Alliance Management LLC Commitment to Diversity and Innovation

The combined expertise and dedication to innovation help clients and patients overcome challenges and lead healthier lives. Clients and patients rely on GI Alliance Management LLC for new strategies and solutions that drive growth and improvement in healthcare.

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Search open positions that match your skills and interests. GI Alliance Management LLC looks for passionate, curious, creative, and solution-driven team players. SEARCH GI ALLIANCE MANAGEMENT LLC JOBS

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Learn more about The GI Alliance Management LLC Company
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Healthcare
* Ladders Estimates

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