Payor Contracting Specialist
Hueman Direct Hire, Chadds Ford, PA, United States
The Payor Contracting Specialist supports Market Access and Payor Development initiatives to expand covered lives, strengthen payer relationships, and improve in-network positioning. This role proactively identifies payer contracting opportunities and supports credentialing and contracting processes to achieve status as an in-network DME provider, while maintaining strong relationships with commercial and government health plans.
This position collaborates closely with Market Access leadership, Revenue Cycle, Operations, Sales, and Clinical teams to ensure payer alignment, accelerate contracting timelines, and support strategic growth initiatives. The ideal candidate is strategic, relationship-driven, and experienced in engaging health plans and supporting payer contracting and development efforts.
KEY RESPONSIBILITIES
Solicit opportunities to submit DME inquiries and applications, supporting the Contract Administrator with credentialing submissions to payors
Follow up on contract submissions, resolve issues, and accelerate timelines to move applications into the contracting phase
Organize and maintain all application and credentialing documentation; keep records up to date and resolve any gaps to highlight value proposition
Maintain tracking systems, contact logs, and activity records to ensure timely follow-up and progress
Identify key contacts within payors and build relationships at application, credentialing, and contracting levels to facilitate workflow and future opportunities
Participate in payor-facing meetings as required
Collaborate across departments to manage covered lives status, operational expansion, and market targeting
Maintain the national payor pipeline report to support Payor Development, Sales, and Operations teams
Gain understanding of commercial and government payers (Medicare, Medicaid) and interpret opportunities within targeted states
Create and maintain commercial payor policy data reports to inform Payor Development strategy
Support the Market Access Lead in the creation of payer-facing collateral, presentations, communications, and internal reporting
Act as a liaison for cross-functional teams on payor development initiatives, including coordination with Operations, Commercial, and Clinical teams
REQUIREMENTS
Experience engaging health plans in contracting, credentialing, or payer development required
Experience working with commercial and government payers, including Medicare and Medicaid
DME experience is strongly preferred, especially across multiple states or regions
Experience supporting payer negotiations and relationship development preferred
Strong organizational, analytical, and problem-solving skills
Excellent verbal and written communication skillsSelf-motivated and able to work independently
Proficient with Excel, PowerPoint, and standard business systems
SKILLS & COMPETENCIES
Strategic thinker with strong relationship-building abilities
Proactive, persistent, and results-oriented approach
Strong organizational and tracking skills with attention to detail
Ability to manage multiple priorities in a fast-paced environment
Strong collaboration skills across cross-functional teams
Ability to identify trends, gaps, and opportunities to improve payer access and operational alignment
SUPERVISORY FUNCTIONS
This position has no supervisory responsibilities
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This position collaborates closely with Market Access leadership, Revenue Cycle, Operations, Sales, and Clinical teams to ensure payer alignment, accelerate contracting timelines, and support strategic growth initiatives. The ideal candidate is strategic, relationship-driven, and experienced in engaging health plans and supporting payer contracting and development efforts.
KEY RESPONSIBILITIES
Solicit opportunities to submit DME inquiries and applications, supporting the Contract Administrator with credentialing submissions to payors
Follow up on contract submissions, resolve issues, and accelerate timelines to move applications into the contracting phase
Organize and maintain all application and credentialing documentation; keep records up to date and resolve any gaps to highlight value proposition
Maintain tracking systems, contact logs, and activity records to ensure timely follow-up and progress
Identify key contacts within payors and build relationships at application, credentialing, and contracting levels to facilitate workflow and future opportunities
Participate in payor-facing meetings as required
Collaborate across departments to manage covered lives status, operational expansion, and market targeting
Maintain the national payor pipeline report to support Payor Development, Sales, and Operations teams
Gain understanding of commercial and government payers (Medicare, Medicaid) and interpret opportunities within targeted states
Create and maintain commercial payor policy data reports to inform Payor Development strategy
Support the Market Access Lead in the creation of payer-facing collateral, presentations, communications, and internal reporting
Act as a liaison for cross-functional teams on payor development initiatives, including coordination with Operations, Commercial, and Clinical teams
REQUIREMENTS
Experience engaging health plans in contracting, credentialing, or payer development required
Experience working with commercial and government payers, including Medicare and Medicaid
DME experience is strongly preferred, especially across multiple states or regions
Experience supporting payer negotiations and relationship development preferred
Strong organizational, analytical, and problem-solving skills
Excellent verbal and written communication skillsSelf-motivated and able to work independently
Proficient with Excel, PowerPoint, and standard business systems
SKILLS & COMPETENCIES
Strategic thinker with strong relationship-building abilities
Proactive, persistent, and results-oriented approach
Strong organizational and tracking skills with attention to detail
Ability to manage multiple priorities in a fast-paced environment
Strong collaboration skills across cross-functional teams
Ability to identify trends, gaps, and opportunities to improve payer access and operational alignment
SUPERVISORY FUNCTIONS
This position has no supervisory responsibilities
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