Payer Partnerships Manager – Healthcare Reimbursement

PDS Health; Irvine (CA); On-site; USD 103,000 - 133,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid time off

Tuition Reimbursement

401K

Volunteer time

Job summary

PDS Health is seeking a Mgr, Plan Partnership to manage strategic relationships with dental and medical payers in the United States. The role supports reimbursement performance, operational efficiency, provider and patient access, and works with internal teams to resolve issues and advance payer strategy.

Responsibilities include managing payer portfolios, negotiating contracts, analyzing reimbursement and trends, and producing executive reports.

Qualifications

• Bachelor's degree in a related field.
• 6+ years of healthcare, dental insurance, managed care, or payer operations experience.
• Experience with commercial insurance, DHMO, PPO, Medicare Advantage and/or Medicaid products.

Responsibilities

• Manage a portfolio of dental and medical payer relationships and partnerships.
• Identify opportunities to improve reimbursement, operations, provider and member experience.
• Support contract negotiations, fee schedules, and implementation activities.
• Analyze claims, utilization, reimbursement trends, and provider performance.
• Prepare reports and executive summaries on partnership performance and financial impact.
• Coordinate cross-functional project plans and stakeholder communications.

Skills

Strategic relationship management

Payer contract negotiations

Healthcare reimbursement expertise

Cross-functional collaboration

Analytical reporting

Leadership and influence

Education

BA/BS in Business/Healthcare Administration/Finance/Public Health

Job description

PDS Health is seeking a Mgr, Plan Partnership to manage strategic relationships with dental and medical payers in the United States. The role supports reimbursement performance, operational efficiency, provider and patient access, and works with internal teams to resolve issues and advance payer strategy.

Responsibilities include managing payer portfolios, negotiating contracts, analyzing reimbursement and trends, and producing executive reports.