Manager - Payer Relations
Department:
Payer Relations & Contracting
Employment Type:
Full Time
Location:
1600 Corporate Center Dr., Monterey Park, CA 91754
Reporting To:
Michael Cotton
Compensation:
$84,852 - $108,894 / year
Description
Job Title: Manager - Payer Relations Department: Payer Relations & Contracting
About the Role: We are currently seeking a highly motivated Manager - Payer Relations. This role will report to the SVP - Payer Contracting and enable us to continue to scale in the healthcare industry.
What You'll Do Owns Health Plan relationships pertaining to day to day issues for all medical groups Drive root cause solutions Ensure Proper administration of DOFRs Oversee and design CAPs arising from Health Plans Oversee project(s) from Health Plans RFPs for vendors Amendments Routine communication / requests to Health Plans Project manage all aspects of Payer and Provider contracting Provide guidance for Payer Relations Associates Efficiently delegate and coordinate the flow of contracts to all relevant stakeholders Interpret and assess risk for provider-facing and payer-facing agreements for time sensitive negotiations Perform Delegation Oversight / Compliance analysis to reduce Astrana's risk exposure and likelihood of incurring penalties, sanctions, and or deductions Work directly with Claims, Configuration, Business Development, and Data Management teams to gather reports regarding data to support proposal Qualifications
Bachelor's Degree required or equivalent experience in the healthcare industry Minimum of 2-3 years of contracting / negotiation / payer / provider relations experience in the healthcare industry Technical backgrounds are a plus with a passion for the healthcare industry You're great for this role if:
High level of comfort working with numbers and large bodies of text Strong problem-solving skills with ability to showcase a methodical approach to troubleshooting You are meticulous, highly organized, and able to engage in exhaustive investigation when initial information is vague Excellent communication skills - both verbal and written. Experience in technical writing is a plus Understands and has experience working within the delegated network environment Strong comfortability with Microsoft Office Suite (Excel, Word, PowerPoint) Very knowledgeable with EZ-Cap and able to understand and work with proprietary software applications - preferred Environmental Job Requirements and Working Conditions
This position is in office. The office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754. The total compensation target pay range for this role is: $84,852.26 - $108,893.73. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Department:
Payer Relations & Contracting
Employment Type:
Full Time
Location:
1600 Corporate Center Dr., Monterey Park, CA 91754
Reporting To:
Michael Cotton
Compensation:
$84,852 - $108,894 / year
Description
Job Title: Manager - Payer Relations Department: Payer Relations & Contracting
About the Role: We are currently seeking a highly motivated Manager - Payer Relations. This role will report to the SVP - Payer Contracting and enable us to continue to scale in the healthcare industry.
What You'll Do Owns Health Plan relationships pertaining to day to day issues for all medical groups Drive root cause solutions Ensure Proper administration of DOFRs Oversee and design CAPs arising from Health Plans Oversee project(s) from Health Plans RFPs for vendors Amendments Routine communication / requests to Health Plans Project manage all aspects of Payer and Provider contracting Provide guidance for Payer Relations Associates Efficiently delegate and coordinate the flow of contracts to all relevant stakeholders Interpret and assess risk for provider-facing and payer-facing agreements for time sensitive negotiations Perform Delegation Oversight / Compliance analysis to reduce Astrana's risk exposure and likelihood of incurring penalties, sanctions, and or deductions Work directly with Claims, Configuration, Business Development, and Data Management teams to gather reports regarding data to support proposal Qualifications
Bachelor's Degree required or equivalent experience in the healthcare industry Minimum of 2-3 years of contracting / negotiation / payer / provider relations experience in the healthcare industry Technical backgrounds are a plus with a passion for the healthcare industry You're great for this role if:
High level of comfort working with numbers and large bodies of text Strong problem-solving skills with ability to showcase a methodical approach to troubleshooting You are meticulous, highly organized, and able to engage in exhaustive investigation when initial information is vague Excellent communication skills - both verbal and written. Experience in technical writing is a plus Understands and has experience working within the delegated network environment Strong comfortability with Microsoft Office Suite (Excel, Word, PowerPoint) Very knowledgeable with EZ-Cap and able to understand and work with proprietary software applications - preferred Environmental Job Requirements and Working Conditions
This position is in office. The office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754. The total compensation target pay range for this role is: $84,852.26 - $108,893.73. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.