Director, Payor Contracting & Rate Negotiations

Central Ohio Primary Care Physicians, Inc.; Westerville (OH); On-site; USD 120,000 - 170,000; Full time

Job summary

Central Ohio Primary Care Physicians, Inc. is seeking a full-time Director of Payor Contracting at our Westerville, OH location.

You will lead end-to-end rate negotiations with commercial, Medicare Advantage, and Medicaid payors, review contracts, and build financial models to support favorable terms. You will coordinate with Clinical Quality and Population Health teams to align VBC terms with organizational goals.

Qualifications

• Bachelor’s degree in Business, Finance, Healthcare Administration or related discipline.
• Minimum seven (7) years’ progressive experience in payor contracting or managed care, including leading rate negotiations.

Responsibilities

• Lead end-to-end rate negotiations with commercial, Medicare Advantage, and Medicaid payors, from strategy development through final execution.
• Review payor contracts, amendments, and fee schedules for accuracy and maintain a centralized contract repository.
• Collaborate with quality teams to monitor VBC performance and renegotiation strategy at renewal.
• Build and maintain financial models to evaluate rates and terms against patient volumes.
• Provide regular status updates on open issues and escalation paths with leadership.
• Audit fee schedules and paid claims to ensure alignment with contract terms and identify underpayments.

Skills

Negotiation

Financial modeling

Data analysis

MS Office (Excel, Word)

Contract management

Education

Bachelor’s Degree in Business/Finance/Healthcare Administration

7+ years payor contracting experience

Tools

Epic (claims/billing) experience

Job description

Central Ohio Primary Care Physicians, Inc. is seeking a full-time Director of Payor Contracting at our Westerville, OH location.

You will lead end-to-end rate negotiations with commercial, Medicare Advantage, and Medicaid payors, review contracts, and build financial models to support favorable terms. You will coordinate with Clinical Quality and Population Health teams to align VBC terms with organizational goals.