Payer Strategy Manager
Ivy Rehab Network, Nashville, TN, United States
Position Summary
The Payer Strategy Manager serves as the primary strategic and operational liaison between the organization and our payor partners. This hybrid role integrates payor contracting management, revenue cycle management collaboration, and operational troubleshooting. The role is responsible for optimizing government contracts, partnering in high‑level negotiations, and removing systemic headwinds to ensure a seamless revenue cycle and maximized reimbursement.
State of Location Tennessee (Remote work allowed; candidates must reside in Eastern or Central Time Zones and may need business travel).
Job Description Join Ivy Rehab’s dedicated team where you’re not just an employee, but a valued teammate! Together, we provide world‑class care in physical therapy, occupational therapy, speech therapy, and applied behavior analysis (ABA) services. Our culture promotes authenticity, inclusion, growth, community, and a passion for exceptional care for every patient.
Key Responsibilities
Payor Advocacy & Strategic Leadership
JOC Management: Create, set agendas for, and lead Joint Operating Committee (JOC) calls with payors to resolve systemic issues.
Contract Negotiation: Lead managed care contract negotiations, primarily with government payors.
Escalation Management: Act as the final point of escalation for complex claims, credentialing disputes, and high‑level third‑party vendor issues.
Contractual Compliance: Ensure the organization maintains current fee schedules and stays updated on timely filing and claim form requirements.
Revenue Cycle & Operational Excellence
Root Cause Analysis: Partner with the RCM team to identify and fix systemic causes for incorrect payments, authorization hurdles, and credentialing gaps.
A/R & Denial Prevention: Collaborate with all parties to develop denial prevention methods and oversee the follow‑up on Accounts Receivable to ensure claims are processed or appealed.
System Integration: Actively engage in the research, set‑up, and testing of new payor information within EMR systems.
Financial Modeling & Reporting
Contract Modeling: Analyze data sets to perform payor contract modeling and evaluate the financial viability of existing and new agreements.
Actionable Insights: Own the delivery of updates for the Monthly Operational Review (MOR) and provide field leadership with actionable performance reporting.
Rate Review: Identify and resolve complex reimbursement issues through targeted data‑driven analysis and rate reviews.
Stakeholder Collaboration
Internal Support: Assist Patient Coordinators (PCs) and patients with billing inquiries; work cross‑functionally to resolve user issues across all departments.
Relationship Management: Maintain professional, direct communication with payors via phone and email to facilitate rapid problem‑solving.
Required Qualifications & Skills
Education: High School Diploma or GED required; Bachelor’s degree in Healthcare Administration or related field preferred.
Experience: 3–5 years of experience in healthcare RCM, managed care, or payor relations. Experience with Raintree EMR is a significant plus.
Technical Proficiency: Advanced skills in Microsoft Office Suite (Excel, Word, Outlook, and Access).
Analytical Ability: Proven ability to analyze complex data sets and develop financial tools for leadership.
Communication: Exceptional oral and written communication skills; comfortable leading professional calls with external stakeholders and presenting to executive leadership.
Soft Skills: High sense of urgency, ability to prioritize tasks in a fast‑paced environment, and commitment to quality customer service.
Physical Requirements & Other Duties
Ability to effectively work from home in a workspace consistent with Ivy’s Work From Home policy.
Performs other duties as assigned to support the growth of the Payor Contracting and RCM teams.
Why Choose Ivy?
Best Employer: Recognized by Modern Healthcare for excellence and outstanding workplace culture.
Exceeding Expectations: Deliver best‑in‑class care and witness exceptional patient outcomes.
Incentives Galore: Eligibility for full benefits package beginning within your first month of employment, generous PTO and paid holidays, hybrid and remote work flexibility.
Empowering Values: Live by values that prioritize teamwork, growth, and serving others.
We are an equal opportunity employer, committed to diversity and inclusion in all aspects of the recruiting and employment process. Actual salaries depend on a variety of factors, including experience, specialty, education, and organizational need. Any listed salary range or contractual rate does not include bonuses/incentive, differential pay, or other forms of compensation or benefits.
ivyrehab.com
#J-18808-Ljbffr
State of Location Tennessee (Remote work allowed; candidates must reside in Eastern or Central Time Zones and may need business travel).
Job Description Join Ivy Rehab’s dedicated team where you’re not just an employee, but a valued teammate! Together, we provide world‑class care in physical therapy, occupational therapy, speech therapy, and applied behavior analysis (ABA) services. Our culture promotes authenticity, inclusion, growth, community, and a passion for exceptional care for every patient.
Key Responsibilities
Payor Advocacy & Strategic Leadership
JOC Management: Create, set agendas for, and lead Joint Operating Committee (JOC) calls with payors to resolve systemic issues.
Contract Negotiation: Lead managed care contract negotiations, primarily with government payors.
Escalation Management: Act as the final point of escalation for complex claims, credentialing disputes, and high‑level third‑party vendor issues.
Contractual Compliance: Ensure the organization maintains current fee schedules and stays updated on timely filing and claim form requirements.
Revenue Cycle & Operational Excellence
Root Cause Analysis: Partner with the RCM team to identify and fix systemic causes for incorrect payments, authorization hurdles, and credentialing gaps.
A/R & Denial Prevention: Collaborate with all parties to develop denial prevention methods and oversee the follow‑up on Accounts Receivable to ensure claims are processed or appealed.
System Integration: Actively engage in the research, set‑up, and testing of new payor information within EMR systems.
Financial Modeling & Reporting
Contract Modeling: Analyze data sets to perform payor contract modeling and evaluate the financial viability of existing and new agreements.
Actionable Insights: Own the delivery of updates for the Monthly Operational Review (MOR) and provide field leadership with actionable performance reporting.
Rate Review: Identify and resolve complex reimbursement issues through targeted data‑driven analysis and rate reviews.
Stakeholder Collaboration
Internal Support: Assist Patient Coordinators (PCs) and patients with billing inquiries; work cross‑functionally to resolve user issues across all departments.
Relationship Management: Maintain professional, direct communication with payors via phone and email to facilitate rapid problem‑solving.
Required Qualifications & Skills
Education: High School Diploma or GED required; Bachelor’s degree in Healthcare Administration or related field preferred.
Experience: 3–5 years of experience in healthcare RCM, managed care, or payor relations. Experience with Raintree EMR is a significant plus.
Technical Proficiency: Advanced skills in Microsoft Office Suite (Excel, Word, Outlook, and Access).
Analytical Ability: Proven ability to analyze complex data sets and develop financial tools for leadership.
Communication: Exceptional oral and written communication skills; comfortable leading professional calls with external stakeholders and presenting to executive leadership.
Soft Skills: High sense of urgency, ability to prioritize tasks in a fast‑paced environment, and commitment to quality customer service.
Physical Requirements & Other Duties
Ability to effectively work from home in a workspace consistent with Ivy’s Work From Home policy.
Performs other duties as assigned to support the growth of the Payor Contracting and RCM teams.
Why Choose Ivy?
Best Employer: Recognized by Modern Healthcare for excellence and outstanding workplace culture.
Exceeding Expectations: Deliver best‑in‑class care and witness exceptional patient outcomes.
Incentives Galore: Eligibility for full benefits package beginning within your first month of employment, generous PTO and paid holidays, hybrid and remote work flexibility.
Empowering Values: Live by values that prioritize teamwork, growth, and serving others.
We are an equal opportunity employer, committed to diversity and inclusion in all aspects of the recruiting and employment process. Actual salaries depend on a variety of factors, including experience, specialty, education, and organizational need. Any listed salary range or contractual rate does not include bonuses/incentive, differential pay, or other forms of compensation or benefits.
ivyrehab.com
#J-18808-Ljbffr