OverviewLead strategic payor negotiations that drive reimbursement success, strengthen partnerships, and support enterprise growth. đź’»
Work Style: Hybrid
đź“Ť
Location: Jacksonville, FL
đź•’
FTE: Full-Time (1.0 FTE)
Leads the negotiation, implementation, and management of payor contracts across the health system. Payor contracts include those agreements between commercial insurers, government payors, and other third-party payors and for hospital, professional and ancillary health system entities. Responsible for developing negotiation strategy, analyzing payor performance, modeling financial impact, and coordinating with internal stakeholders to optimize contract value and operational performance. Serves as a subject-matter expert on reimbursement methodologies, payor policies, and value-based contracting.
ResponsibilitiesKey Responsibilities- Lead and support payor contract negotiations to achieve favorable reimbursement and operational outcomes.
- Analyze financial and reimbursement data to support contract strategy, modeling, and decision-making.
- Review, interpret, and manage complex payor contract terms, methodologies, and regulatory requirements.
- Develop and maintain strong relationships with payors, executive leadership, and internal stakeholders.
- Prepare executive-level reports, presentations, and recommendations related to managed care performance and strategy.
- Coordinate and manage multiple contract initiatives and projects within a fast-paced healthcare environment.
- Collaborate with finance, legal, compliance, and operational teams to support contract implementation and oversight.
- Monitor contract performance, identify opportunities for improvement, and support strategic initiatives across the organization.
QualificationsMinimum RequirementsEducation- Bachelor's degree required in Business, Healthcare Administration, Finance, Economics, or a related field.
- Master's degree strongly preferred.
Experience- Minimum of five (5) years of experience in managed care contracting, payor/provider negotiations, healthcare finance, or a related field.
- Experience negotiating complex commercial and governmental payor contracts required.
- Health system and/or payor-side experience strongly preferred.
