Payer Contract Manager Sr

MultiCare; United States; Remote; USD 102,000 - 146,000; Full time

Job summary

MultiCare Health System is seeking a Senior Payer Contract Manager to develop and negotiate contracts with third-party payers. You will lead payer negotiations, align terms with various reimbursement models, and manage ongoing payer relationships across affiliates.

In this role you will ensure contracts comply with applicable laws and support revenue growth while reducing cost to care. A strong background in healthcare contracting and pricing terminology is required.

Qualifications

• Bachelor's degree with a major in finance, Healthcare administration, or related field; or 10+ years’ experience in Payer Contracting.
• Minimum seven (7) years of experience performing financial/medical data/payer mix analysis or contract negotiation in a healthcare environment.
• Experience with medical and pricing terminology including DRG, RUG, APC, RVU, Conversion Factors.

Responsibilities

• Lead negotiations with assigned payers to include payment terms across multiple models.
• Manage payer relationships and advise on product participation.
• Ensure contracts align with State and Federal laws and minimize financial risk.

Skills

Payer contracting

Financial analysis

Contract negotiation

Healthcare payer data

Education

Bachelor's degree in finance, Healthcare administration, or related field

Job description

Join a team that shares your calling At MultiCare, you’re more than just a job title — you’re part of a team built on trust that cares for each other, our patients and our communities. Belonging here means living our mission and values every day. If your purpose and passions align with ours, you’ll find a place to grow, do meaningful work and build a career you love in a community that feels like home. FTE: 1.0, Shift: Day, Schedule: Day Position Summary The Senior Payer Contract Manager is responsible for developing and implementing contracts with third party payers on behalf of MultiCare Health System and its affiliates. This role ensures MultiCare, and our affiliates have consistent and well-functioning relationships with payers over time, in alignment with MultiCare’s vision and strategic priorities. The Manager will lead negotiations with assigned payers to include payment terms based on multiple reimbursement models, including fee-for-service payment terms, value-based payment terms, and gain/risk sharing arrangements. The Manager serves as the lead managing the overall payer relationship, makes recommendations to Sr. Leadership on product participation, and will continually evaluate the payer relationship for opportunities to improve revenue, lower the cost of doing business, and to improve MultiCare’s access to patents. The Manager is accountable for negotiating contract language that aligns with all State and Federal laws and regulations, is consistent across payers, and does not expose MultiCare financial, legal, or operational risk to MultiCare or the payer.

Requirements

• Bachelors degree with a major in finance, Healthcare administration, or related field; or 10+ years’ experience in Payer Contracting for a Health System or Health Plan as degree equivalent
• Minimum seven (7) years of experience performing financial/medical data/payer mix analysis or contract negotiation in a healthcare environment, health system or health plan; acute care setting experience preferred
• Experience with medical and pricing terminology to include but not limited to DRG, RUG, APC, RVU, Conversion Factors

Why MultiCare?

• Rooted in the local community
• Partnering with patients, families and neighbors across the Pacific Northwest for more than 140 years.
• Growth and education Competitive tuition assistance, award-winning residencies, fellowships and career development to invest in you.
• Well-being and support Generous PTO, Code Lavender and Employee Assistance Programs to help you maintain balance and feel cared in your work and life.
• Living our values Respect, integrity, kindness and collaboration guide how we care for patients, communities and each other.
• Belonging for all Resource Groups and outreach programs help ensure every team member feels safe, seen, heard and valued.
• Pacific Northwest lifestyle Work and live where natural beauty, adventure and strong community connections are part of everyday life.

Pay and Benefit Expectations

• We provide a comprehensive benefits package, including competitive salary, medical, dental and retirement benefits and paid time off.
• As required by various pay transparency laws, we share a competitive range of compensation for candidates hired into each position. The pay scale is $101,545.60 - $146,140.80 USD.
• However, pay is influenced by factors specific to applicants, including but not limited to: skill set, level of experience, and certification(s) and/or education.
• If this position is associated with a union contract, pay will be reflective of the appropriate step on the pay scale to which the applicant’s years of experience align.
• Associated benefit information can be viewed here.

MultiCare is a not-for-profit health care organization with more than 28,000 team members, including employees, providers and volunteers. MultiCare has been caring for our community for well over a century, since the founding of Tacoma’s first hospital and today is the largest community-based, locally governed system of health in the state of Washington, serving communities across Washington and Northern Idaho. MultiCare’s comprehensive system of health includes numerous primary care, urgent care and specialty services — including Mary Bridge Children’s Hospital & Health Network; MultiCare Indigo Urgent Care; Pulse Heart Institute; MultiCare Medical Associates, affiliated physicians; MultiCare Rockwood Clinic, the largest multispecialty clinic in the Inland Northwest region; and MultiCare Connected Care, our Accountable Care Organization. Thirteen hospitals complete the organization: Allenmore Hospital, Auburn Medical Center, Capital Medical Center, Covington Medical Center, Deaconess Hospital, Good Samaritan Hospital, Mary Bridge Children’s Hospital — the Puget Sound region’s only children’s hospital and state-designated Level II Pediatric Trauma Center for Western Washington — Overlake Medical Center, Navos Behavioral Health Hospital, Valley Hospital, Yakima Valley Hospital, Tacoma General Hospital — which is home to the South Puget Sound region’s only Level IV Neonatal Intensive Care Unit — and Wellfound Behavioral Health Hospital. Our core values of Respect, Integrity, Stewardship, Excellence, Collaboration, Kindness and Joy, serve as our guiding principles and impact every aspect of our organization, including how we provide patient care and what we expect from each other. MultiCare is also proud of our commitment to workforce diversity and culturally competent care. This commitment is led by our CEO and supported through employee education and community outreach.

MultiCare provides equal employment opportunity to all employees and job applicants. We do not tolerate discrimination or harassment based on race, color, religion, age, sex, national origin, disability status, genetic information, protected veteran status, sexual orientation, gender identity or expression or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination layoff, recall, transfer, leaves of absence, compensation and training. If you are an external job applicant who requires reasonable accommodation in the job application process, please contact the Employee Resource Center (ERC) at 253-403-6947 and we’ll assist you with submitting a ticket to initiate your request for accommodation. If you are a current employee, you can submit an ERC ticket or call the ERC for assistance.