Manager of Payer Contracting and Reimbursement

Interim HealthCare Inc.

Columbus (OH)

On-site

USD 90,000 - 120,000

Full time

5 days ago
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Job summary

Interim HealthCare Inc. in Columbus, OH is seeking a Manager of Payer Contracting and Reimbursement to lead payer contract development, negotiation, and ongoing management for home health and hospice services.

You will coordinate with Finance, Revenue Cycle, Operations, and Clinical Leadership to expand payer network participation and ensure compliant, favorable reimbursement terms. The role requires five+ years in payer contracting or related finance roles, strong negotiation and analytics

Qualifications

  • Minimum of five years of healthcare payer contracting, managed care, provider relations, reimbursement, or healthcare finance experience.
  • Demonstrated experience negotiating contracts with commercial health plans, Medicare Advantage organizations, and Medicaid Managed Care entities.
  • Knowledge of home health, hospice, post‑acute care, or related healthcare reimbursement models.
  • Strong financial analysis, forecasting, and contract evaluation skills.
  • Excellent negotiation, communication, and relationship management abilities.

Responsibilities

  • Lead all payer contract negotiations, renewals, amendments, and terminations.
  • Develop and execute contracting strategies designed to improve reimbursement rates, strengthen market position, and support organizational growth objectives.
  • Serve as the organization's primary point of contact for payer representatives, provider relations teams, and network managers.
  • Partner with Revenue Cycle, Billing, Finance, Operations, and Clinical Leadership to ensure successful implementation of payer agreements.
  • Monitor federal, state, and payer-specific regulations affecting reimbursement and managed care contracting.

Skills

Negotiation
Financial analysis
Contract management

Education

Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or related field

Job description

Manager of Payer Contracting and Reimbursement

We are seeking a Manager of Payer Contracting and Reimbursement. Reports to the Senior Director of Sales and is responsible for leading the development, negotiation, implementation, and ongoing management of payer contracts that support the organization's home health and hospice service lines. This role serves as the primary liaison between the organization and commercial insurance payers, Medicare Advantage plans, Medicaid Managed Care organizations, and other third‑party reimbursement entities.

The Manager is responsible for securing favorable reimbursement agreements, expanding payer network participation, evaluating contract performance, and identifying opportunities to enhance revenue and profitability. This position works collaboratively with Finance, Revenue Cycle, Operations, Clinical Leadership, Business Development, and Executive Leadership to support organizational growth, market expansion, and operational excellence. The role also provides oversight of credentialing activities to ensure timely provider enrollment and compliance with payer requirements.

Essential Responsibilities
  • Ability to work a flexible schedule, including occasional evenings, as business needs require.
  • Ability to travel locally and occasionally overnight for payer meetings, conferences, and organizational initiatives.
  • Lead all payer contract negotiations, renewals, amendments, and terminations.
  • Develop and execute contracting strategies designed to improve reimbursement rates, strengthen market position, and support organizational growth objectives.
  • Serve as the organization's primary point of contact for payer representatives, provider relations teams, and network managers.
  • Establish and maintain strong strategic partnerships with key payer organizations.
  • Partner with Revenue Cycle, Billing, Finance, Operations, and Clinical Leadership to ensure successful implementation of payer agreements.
  • Support strategic initiatives related to service‑line expansion, new market development, and acquisitions.
  • Monitor federal, state, and payer‑specific regulations affecting reimbursement and managed care contracting.
  • Ensure compliance with CMS regulations, Medicare requirements, Medicaid guidelines, and contractual obligations.
To qualify for a Manager of Payer Contracting and Reimbursement with us
Required
  • Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field.
  • Minimum of five years of healthcare payer contracting, managed care, provider relations, reimbursement, or healthcare finance experience.
  • Demonstrated experience negotiating contracts with commercial health plans, Medicare Advantage organizations, and Medicaid Managed Care entities.
  • Knowledge of home health, hospice, post‑acute care, or related healthcare reimbursement models.
  • Strong financial analysis, forecasting, and contract evaluation skills.
  • Excellent negotiation, communication, and relationship management abilities.
  • Experience managing multiple projects and priorities in a fast‑paced environment.
Preferred
  • Experience in home health, hospice, or post‑acute care settings.
  • Multi‑state payer contracting experience.
  • Experience with value‑based purchasing, risk‑sharing arrangements, and alternative payment models.
  • Supervisory or leadership experience within contracting, reimbursement, or credentialing functions.
Knowledge, Skills, And Abilities
  • Knowledge of healthcare payer contracting, reimbursement methodologies, managed care, and revenue cycle operations.
  • Understanding of Medicare, Medicare Advantage, Medicaid Managed Care, and commercial payer structures.
What we offer

Competitive Salary up & benefits

Working at Interim HealthCare means a career unlike any other. With integrity at the center of all we do, we know that when we support you and your community, you'll change lives every day.

At Interim Healthcare Home Care, our patients deserve the very best - that's why we focus on each individual's needs in the comfort and dignity of their home. Through nursing, personal care, therapy, case management, and countless specialized services, we bring quality care where it's needed most. We're called to care so that family members can be just that.

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

#RMC

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