Payor Contract & Project Manager (Hybrid)

Southwestern Health Resources; Dallas (TX); Hybrid; USD 80,000 - 110,000; Full time

Benefits offered by this job

Hybrid position

Mentorship

Training programs

Leadership resources

Job summary

Southwestern Health Resources is seeking a skilled Payor Analyst to review and interpret payor contracts, track key terms, and prepare amendments. The role supports contract operations, project management, and cross-functional initiatives within a hybrid work model with limited onsite days.

You will collaborate with providers, payors, and internal teams to resolve issues, monitor timelines, and communicate financial impacts.

Qualifications

• Bachelor's Degree in Business or Healthcare, 4 years required, or Master's degree preferred.
• 4+ years of experience in managed care, payor relations, or healthcare operations.
• Familiarity with healthcare payor systems and contract language.
• Excellent project management and problem-solving skills.
• Strong analytical and communication skills.

Responsibilities

• Review and interpret payor contracts to understand contract language, financial incentives, and other relevant items of the contract.
• Assist with maintaining contract language key terms by payor tracking grid.
• Prepare routing documents for new contracts and amendments.
• Review and redline low-level amendments (e.g., term extensions, quality measure updates) and exhibits.
• Complete and distribute new contract orientation forms and communications to internal stakeholders.
• Maintain organized records of contract status, amendments, and stakeholder communications.
• Maintain project tracker by payor and monitor project status.
• Participate in payor calls, identify trends, and document outcomes.
• Escalate unresolved issues to appropriate parties and follow through to resolution.
• Maintain and update project trackers, ensuring alignment with stakeholders and timelines.
• Interpret and communicate contract changes to internal stakeholders.
• Collaborate with analysts to assess financial implications of new contracts or amendments.
• Notify payors of significant impacts within required timeframes and monitor resolution status.
• Document and communicate new contracts and changes to relevant teams.
• Support cross-functional managed care initiatives and respond to provider or payor queries.
• Communicate with providers, payors, and internal stakeholders to resolve issues and improve processes.
• Collect, organize, and present data in a clear format.
• Provide timely updates and final reports to requesting departments or leadership.
• Ensure all project documentation is complete, accurate, and accessible.
• Represent the Market and Payor Relations team in committees and workgroups.

Skills

Payor systems

Contract language

Project management

Analytical skills

Communication skills

Education

Bachelor's degree in Business/Healthcare

Master's degree preferred

Job description

Southwestern Health Resources is seeking a skilled Payor Analyst to review and interpret payor contracts, track key terms, and prepare amendments. The role supports contract operations, project management, and cross-functional initiatives within a hybrid work model with limited onsite days.

You will collaborate with providers, payors, and internal teams to resolve issues, monitor timelines, and communicate financial impacts.