Payor Contracting Specialist

Hueman Direct Hire; Chadds Ford (Delaware County); On-site; USD 70,000 - 90,000; Full time

Job summary

A healthcare staffing company is seeking a Payor Contracting Specialist to support Market Access and Payor Development initiatives. Responsibilities include engaging health plans, managing credentialing processes, and ensuring timelines are met. Candidates should have experience in contracting, strong organizational and analytical skills, and must be proficient with Excel and PowerPoint. This is a key role that requires collaboration across multiple departments and the ability to build strong relationships with payers.

Qualifications

• Experience engaging health plans in contracting, credentialing, or payer development required.
• DME experience is strongly preferred, especially across multiple states or regions.
• Excellent verbal and written communication skills.

Responsibilities

• Solicit opportunities to submit DME inquiries and applications.
• Organize and maintain all application and credentialing documentation.
• Collaborate across departments to manage covered lives status.

Skills

Engaging health plans

Contracting experience

Strong organizational skills

Analytical skills

Relationship-building abilities

Tools

Excel

PowerPoint

Job description

The Payor Contracting Specialist supports Market Access and Payor Development initiatives to expand covered lives, strengthen payer relationships, and improve in-network positioning. This role proactively identifies payer contracting opportunities and supports credentialing and contracting processes to achieve status as an in-network DME provider, while maintaining strong relationships with commercial and government health plans.

This position collaborates closely with Market Access leadership, Revenue Cycle, Operations, Sales, and Clinical teams to ensure payer alignment, accelerate contracting timelines, and support strategic growth initiatives. The ideal candidate is strategic, relationship-driven, and experienced in engaging health plans and supporting payer contracting and development efforts.

KEY RESPONSIBILITIES

• Solicit opportunities to submit DME inquiries and applications, supporting the Contract Administrator with credentialing submissions to payors
• Follow up on contract submissions, resolve issues, and accelerate timelines to move applications into the contracting phase
• Organize and maintain all application and credentialing documentation; keep records up to date and resolve any gaps to highlight value proposition
• Maintain tracking systems, contact logs, and activity records to ensure timely follow-up and progress
• Identify key contacts within payors and build relationships at application, credentialing, and contracting levels to facilitate workflow and future opportunities
• Participate in payor-facing meetings as required
• Collaborate across departments to manage covered lives status, operational expansion, and market targeting
• Maintain the national payor pipeline report to support Payor Development, Sales, and Operations teams
• Gain understanding of commercial and government payers (Medicare, Medicaid) and interpret opportunities within targeted states
• Create and maintain commercial payor policy data reports to inform Payor Development strategy
• Support the Market Access Lead in the creation of payer-facing collateral, presentations, communications, and internal reporting
• Act as a liaison for cross-functional teams on payor development initiatives, including coordination with Operations, Commercial, and Clinical teams

REQUIREMENTS

• Experience engaging health plans in contracting, credentialing, or payer development required
• Experience working with commercial and government payers, including Medicare and Medicaid
• DME experience is strongly preferred, especially across multiple states or regions
• Experience supporting payer negotiations and relationship development preferred
• Strong organizational, analytical, and problem-solving skills
• Excellent verbal and written communication skillsSelf-motivated and able to work independently
• Proficient with Excel, PowerPoint, and standard business systems

SKILLS & COMPETENCIES

• Strategic thinker with strong relationship-building abilities
• Proactive, persistent, and results-oriented approach
• Strong organizational and tracking skills with attention to detail
• Ability to manage multiple priorities in a fast-paced environment
• Strong collaboration skills across cross-functional teams
• Ability to identify trends, gaps, and opportunities to improve payer access and operational alignment

SUPERVISORY FUNCTIONS

• This position has no supervisory responsibilities