Director of Payer Relations – Contracting

Jobtailor; Deutschland; Remote; EUR 90.000 - 130.000; Vollzeit

Zusammenfassung

Jobtailor seeks a senior leader to develop and execute a regional payer strategy aligned with enterprise goals for access, rate performance, and network positioning. You will own the full contracting lifecycle for assigned payers and markets, including opportunity assessment, proposal development, negotiation, redlining, and execution of new, renewal, and amended agreements.

You will identify opportunities for improved terms, manage performance against contracted terms, lead renegotiations, and

Qualifikationen

• Bachelor’s degree required in business, healthcare, finance, public policy, or related field.
• 7+ years in managed care contracting, payer relations, or growth in healthcare.
• Behavioral health or ABA experience preferred.
• Experience negotiating commercial or Medicaid agreements with complex reimbursement.
• Strong financial and analytical skills; rate modeling and claims data interpretation.

Aufgaben

• Develop and execute a regional payer strategy aligned with enterprise goals for access, rate performance, and network positioning.
• Own the full contracting lifecycle for assigned payers and markets, incl. opportunity assessment, proposal development, negotiation, redlining, and execution of new/renewal/amended agreements.
• Prioritize payers and products based on volumes, out-of-network exposure, and strategic growth needs.
• Identify opportunities for improved terms, including rate optimization, escalators, modifiers, site-of-service, and administrative simplification.
• Maintain an accurate view of regional contracts and key financial terms.
• Track performance against contracted terms, including allowed amounts, denial patterns, and overpayments/underpayments.
• Drive renegotiation strategies, corrective actions, and payer escalations.
• Serve as primary relationship owner for regional payer partners.

Kenntnisse

Managed Care Contracting

Payer Relations

Negotiation

Financial Analysis

Rate Modeling

Ausbildung

Bachelor’s degree in Business, Healthcare Administration, Finance, Public Policy, or related field

Tools

Contract Lifecycle Mgmt

Proposal Development

Rate Optimization

Claims Data Interpretation

Scenario Analysis

Jobbeschreibung

• Develop and execute a regional payer strategy aligned with enterprise goals for access, rate performance, and network positioning
• Own the full contracting lifecycle for assigned payers and markets, including opportunity assessment, proposal development, negotiation, redlining, and execution of new, renewal, and amended agreements
• Prioritize payers and products based on volumes, out-of-network exposure, and strategic growth needs
• Identify opportunities for improved terms, including rate optimization, escalators, modifiers, site-of-service and telehealth rules, and administrative simplification
• Maintain an accurate view of regional contracts and key financial and operational terms
• Track performance against contracted terms, including allowed amounts, denial patterns, and under/overpayments
• Drive renegotiation strategies, corrective actions, and payer escalations
• Serve as primary relationship owner for regional payer partners
• Lead regular business reviews addressing performance, operational issues, and new program opportunities
• Advocate for ABA-specific needs and collaborate on value-based programs, quality incentives, and alternative payment models
• Partner with Regional Operations Leaders to shape contracting priorities based on center-level needs
• Support new site openings, expansions, and acquisitions by securing payer participation, rates, and timelines
• Guide operations, intake, and scheduling teams on payer-specific rules, coverage, and authorization requirements
• Work with Growth/Business Development teams on RFP/RFI responses and partnership opportunities
• Partner with Legal, Compliance, and Risk on regulatory and policy alignment
• Prepare summaries and presentations for senior leadership
• Mentor and support Contract Managers and analysts

Requirements

• Bachelor’s degree in Business, Healthcare Administration, Finance, Public Policy, or related field required
• 7+ years of experience in managed care contracting, payer relations, or growth functions within healthcare
• Behavioral health or ABA experience strongly preferred
• Demonstrated success negotiating commercial and/or Medicaid agreements, including complex reimbursement and performance-based structures
• Strong financial and analytical skills
• Experience with rate modeling, scenario analysis, and interpretation of claims data

Demonstrates expertise in managed care contracting and payer relations, with a strong focus on negotiation, financial analysis, and strategic growth within the healthcare sector. Proven ability to lead contract lifecycle management and advocate for value-based programs and quality incentives.

Highest-signal resume keywords

• Managed Care Contracting
• Payer Relations
• Negotiation of Commercial Agreements
• Financial Analysis
• Rate Modeling

Hard Skills

• Contract Lifecycle Management
• Proposal Development
• Rate Optimization
• Claims Data Interpretation
• Scenario Analysis

Soft Skills

• Relationship Management
• Mentoring
• Collaboration

Industry Keywords

• Healthcare Administration
• Behavioral Health
• ABA
• Performance-Based Structures
• Alternative Payment Models