Description

Manager of Payer Contracting and Reimbursement

• Ability to work a flexible schedule, including occasional evenings, as business needs require.

• Ability to travel locally and occasionally overnight for payer meetings, conferences, and organizational initiatives.

We are seeking a Manager of Payer Contracting and Reimbursement. Reports to the Senior Director of Sales and is responsible for leading the development, negotiation, implementation, and ongoing management of payer contracts that support the organization's home health and hospice service lines. This role serves as the primary liaison between the organization and commercial insurance payers, Medicare Advantage plans, Medicaid Managed Care organizations, and other third-party reimbursement entities.

The Manager is responsible for securing favorable reimbursement agreements, expanding payer network participation, evaluating contract performance, and identifying opportunities to enhance revenue and profitability. This position works collaboratively with Finance, Revenue Cycle, Operations, Clinical Leadership, Business Development, and Executive Leadership to support organizational growth, market expansion, and operational excellence. The role also provides oversight of credentialing activities to ensure timely provider enrollment and compliance with payer requirements.

What we offer our Manager of Payer Contracting and Reimbursement:

Competitive Salary up & benefits

Excited to hear more? Apply Below:

As a Manager of Payer Contracting and Reimbursement, you will:

Essential Responsibilities:

Payer Contracting and Negotiation
• Lead all payer contract negotiations, renewals, amendments, and terminations.
• Develop and execute contracting strategies designed to improve reimbursement rates, strengthen market position, and support organizational growth objectives.

Payer Relationship Management
• Serve as the organization's primary point of contact for payer representatives, provider relations teams, and network managers.
• Establish and maintain strong strategic partnerships with key payer organizations.

Reimbursement Analysis and Financial Performance

Cross-Functional Leadership and Collaboration
• Partner with Revenue Cycle, Billing, Finance, Operations, and Clinical Leadership to ensure successful implementation of payer agreements.
• Support strategic initiatives related to service-line expansion, new market development, and acquisitions.

Compliance and Regulatory Oversight
• Monitor federal, state, and payer-specific regulations affecting reimbursement and managed care contracting.
• Ensure compliance with CMS regulations, Medicare requirements, Medicaid guidelines, and contractual obligations.

To qualify for a Manager of Payer Contracting and Reimbursement with us:

Required:
• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field.
• Minimum of five years of healthcare payer contracting, managed care, provider relations, reimbursement, or healthcare finance experience.
• Demonstrated experience negotiating contracts with commercial health plans, Medicare Advantage organizations, and Medicaid Managed Care entities.
• Knowledge of home health, hospice, post-acute care, or related healthcare reimbursement models.
• Strong financial analysis, forecasting, and contract evaluation skills.
• Excellent negotiation, communication, and relationship management abilities.
• Experience managing multiple projects and priorities in a fast-paced environment.

Preferred:
• Experience in home health, hospice, or post-acute care settings.
• Multi-state payer contracting experience.
• Experience with value-based purchasing, risk-sharing arrangements, and alternative payment models.
• Supervisory or leadership experience within contracting, reimbursement, or credentialing functions.

Knowledge, Skills, and Abilities
• Knowledge of healthcare payer contracting, reimbursement methodologies, managed care, and revenue cycle operations.
• Understanding of Medicare, Medicare Advantage, Medicaid Managed Care, and commercial payer structures.

At Interim Healthcare Home Care, our patients deserve the very best - that's why we focus on each individual's needs in the comfort and dignity of their home. Through nursing, personal care, therapy, case management, and countless specialized services, we bring quality care where it's needed most. We're called to care so that family members can be just that.

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