Manager, Payor Relations – Southern Region

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

Zusammenfassung

Jobtailor is seeking a senior healthcare operations leader to drive payer contracting and network development across southern states, coordinating with a three-person team to negotiate contracts and expand relationships with health plans.

You will oversee policy escalations, data configuration in internal systems, and cross-functional collaboration with Legal, Compliance, Revenue Cycle, Sales, and Operations, while maintaining HIPAA/patient confidentiality and coordinating quarterly travel.

Qualifikationen

• 5+ years in healthcare operations, network development, or managed care contracting.
• Provider, hospital, or DME experience preferred.
• Proven experience negotiating contracts with health plans or providers.
• Demonstrated success managing and developing teams, especially those newer to the industry or function.
• Experience with Medicaid, Medicare, Commercial, IPAs, and TPAs.
• Strong understanding of claims workflows and payer/provider relationships.
• Ability to manage escalations, coach team members, and implement scalable processes.
• Located within 1 hour of a major airport preferred, with strong preference for the Northeast region.
• Experience managing cross-functional projects and reporting to multiple stakeholders or leaders preferred.
• Experience with fee schedule configuration and payer system setup preferred.
• Familiarity with payer compliance and policy monitoring preferred.
• Must maintain HIPAA/patient confidentiality
• Knowledge of and compliance with applicable laws, regulations, and policies is required.
• Ability to travel quarterly to Aeroflow’s corporate office
• Equal opportunity and compliance with workplace policies

Aufgaben

• Lead payer contracting and network development strategy across southern states, including Medicaid, Medicare, Commercial, IPAs, and TPAs.
• Manage and develop a high-performing team of three contracting professionals
• Build and maintain relationships with health plans
• Lead negotiations, policy escalations, and network development
• Drive payer network expansion, payer policy change, and fee schedule negotiations
• Ensure payer contract data is accurately updated and configured in internal systems
• Collaborate with Legal, Compliance, Revenue Cycle, Sales, and Operations
• Lead and contribute to cross-functional projects with multiple stakeholders
• Manage priorities with clear communication
• Audit internal processes and coach team members for compliance, alignment, and continuous improvement
• Coach and support the team on payer expansion, policy changes, contract negotiation, and configuration
• Lead or participate in company-wide payer strategy projects
• Refine processes and develop the team to ensure accuracy, clarity, and effectiveness
• Maintain HIPAA and patient confidentiality

Kenntnisse

Payer contracting

Network development

Team management

Contract negotiations

Payer compliance

Cross-functional collaboration

Leadership

Communication

Process improvement

Tools

Payer system setup

Jobbeschreibung

• Lead payer contracting and network development strategy across southern states, including Medicaid, Medicare, Commercial, IPAs, and TPAs
• Manage and develop a high-performing team of three contracting professionals
• Build and maintain relationships with health plans
• Lead negotiations, policy escalations, and network development
• Drive payer network expansion, payer policy change, and fee schedule negotiations
• Ensure payer contract data is accurately updated and configured in internal systems
• Collaborate with Legal, Compliance, Revenue Cycle, Sales, and Operations
• Lead and contribute to cross-functional projects with multiple stakeholders
• Manage priorities with clear communication
• Audit internal processes and coach team members for compliance, alignment, and continuous improvement
• Coach and support the team on payer expansion, policy changes, contract negotiation, and configuration
• Lead or participate in company-wide payer strategy projects
• Refine processes and develop the team to ensure accuracy, clarity, and effectiveness
• Maintain HIPAA and patient confidentiality

Requirements

• 5+ years in healthcare operations, network development, or managed care contracting
• Provider, hospital, or DME experience preferred
• Proven experience negotiating contracts with health plans or providers
• Demonstrated success managing and developing teams, especially those newer to the industry or function
• Experience with Medicaid, Medicare, Commercial, IPAs, and TPAs
• Strong understanding of claims workflows and payer/provider relationships
• Ability to manage escalations, coach team members, and implement scalable processes
• Located within 1 hour of a major airport preferred, with strong preference for the Northeast region
• Experience managing cross-functional projects and reporting to multiple stakeholders or leaders preferred
• Experience with fee schedule configuration and payer system setup preferred
• Familiarity with payer compliance and policy monitoring preferred
• Must maintain HIPAA/patient confidentiality
• Knowledge of and compliance with applicable laws, regulations, and policies is required
• Ability to travel quarterly to Aeroflow’s corporate office
• Equal opportunity and compliance with workplace policies

Core Competencies

Demonstrates expertise in payer contracting, network development, and team management within the healthcare sector, with a strong focus on compliance, negotiation, and cross-functional collaboration.

Highest-signal resume keywords

• Payer Contracting
• Network Development
• Team Management
• Contract Negotiation
• Payer Compliance

ATS Optimization Keywords

Hard Skills

• Healthcare Operations
• Managed Care Contracting
• Claims Workflow Understanding
• Fee Schedule Configuration
• Payer System Setup

Soft Skills

• Clear Communication
• Coaching
• Process Improvement
• Relationship Building

Certifications & Qualifications

• HIPAA Compliance

Industry Keywords

• Medicaid
• Medicare
• Commercial
• IPAs
• TPAs
• Provider Relationships
• Policy Monitoring