Payor Contract Negotiator Senior

WellSpan Health; York (York County); On-site; USD 95,000 - 125,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement savings plan

Paid time off

Education assistance

DailyPay

Expanded parental leave

Job summary

WellSpan Health is seeking a seasoned Payor Contract Negotiator to manage large third‑party negotiations (Medicaid and others) to secure fair payment terms and operational clarity. You will memorialize terms in written agreements and ensure compliance, working independently with discretion and cross‑functional collaboration.

Requires 3+ years in health system revenue cycle/payor negotiation, a bachelor’s degree in finance/health administration, and strong analytical and negotiation skills.

Qualifications

• Requires excellent written and oral communication.
• Strong interpersonal and computer skills.
• Analytical, negotiation and project management abilities.

Responsibilities

• Supports professional and collaborative relationships with payors and team members.
• Manages active contract negotiation processes to ensure terms are addressed and administrative processes are controlled.
• Manages the assigned payor book of business including Commercial, Medicare Advantage, Medicaid for PA and MD.
• Analyzes financial impact of contract changes and negotiates rate or language updates with payors.
• Ensures proposed programs are memorialized in written agreements and understood by relevant staff.
• Keeps knowledge current on market activities, plans, programs and regulatory changes.

Skills

Communication skills

Interpersonal skills

Analytical skills

Education

Bachelor’s degree in Finance/Accounting/Management/Health Care Administration

Master’s degree in Management/HealthCare Administration/Finance/Payor Relationships

Job description

Job Overview

Manages large third-party payor contract negotiations (such as Medicaid) to ensure fair and adequate payment rates, methodology, and acceptable operational terms, while memorializing these terms in written agreements. Assures payor compliance with contract financial terms and works independently, exercising judgment and discretion. Collaborates with strategic WellSpan Health Payors.

Responsibilities

• Supports professional and collaborative relationships with payors and team members.
• Manages active contract negotiation processes to ensure system contracting terms are adequately addressed and the administrative process is controlled effectively on behalf of the health system.
• Manages the assigned payor book of business, including Commercial, Medicare Advantage, Medicaid for both PA and MD based providers.
• Analyzes the financial impact of contract reimbursement, policy, or language changes/initiatives in conjunction with the business manager and operational staff. Negotiates with payors to resolve issues via rate or language updates.
• Ensures that proposed, new, and/or changed contractual programs are attainable within the organization, accurately memorialize agreed terms, and that appropriate WellSpan Health personnel are educated on changes.
• Maintains knowledge of industry‑accepted contractual arrangements, financial opportunities, operational challenges, and other payor initiatives, including state and federal MCO regulatory programs.
• Participates in the strategic improvement of payor contracts as part of the Contract Integration Team and with Chief Clinical Directors, Directors of Quality, Administrative Vice Presidents, Quality and Clinical Improvement Managers, ancillary and hospital leadership, and payors.
• Monitors and stays current on market activities and changes related to health insurance plans, programs, and regulations.
• Researches and reports on specific requests, as assigned.
• Participates in annual education, committees, and educational offerings.
• Manages WellSpan Health’s third‑party facility, ancillary, behavioral health, hospice, and dental payor contract negotiations to ensure fair and adequate payment rates and methodology and acceptable operational terms, memorializing terms in written agreements.
• Works independently and exercises judgment and discretion.

Common Expectations

• Continuously assesses payor performance and implements appropriate quality control and assessment programs.
• Enhances professional growth through participation in educational programs, literature in‑service meetings, and workshops.
• Provides outstanding service, fosters teamwork, and practices fiscal responsibility through improvement and innovation.
• Participates in continuous assessment and improvement of the department/service line/entity/systems performance.
• Demonstrates strong negotiation and presentation skills.

Travel Requirements

• Estimated 10% local and regional travel.

Qualifications

• Minimum Education: Bachelor’s Degree in Finance, Accounting, Management, and/or Health Care Administration (Required).
• Preferred: Master’s Degree in Management, HealthCare Administration, Finance, or Payor Relationships.

Work Experience

• 3 years of working knowledge of Health System Revenue Cycle operations and payment methodologies and an overall understanding of various aspects of health care financing (Required).
• 5 years of healthcare reimbursement, third‑party payor negotiation/operations, or regulatory experience (Preferred).

Courses and Training

• Finance, Data Analysis, Contract Negotiation – Upon hire required.

Knowledge, Skills, and Abilities

• Excellent written and oral communication skills.
• Interpersonal and computer skills.
• Analytical, negotiation, and project management skills.
• Ability to work well in a team.

Benefits Offered

• Comprehensive health benefits.
• Retirement savings plan.
• Paid time off (PTO).
• Education assistance.
• Financial education and support, including DailyPay.
• Expanded paid parental leave.